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HEAD S
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R E S E A R C H
Pathways to Quality and Full
Implementation in Early Head
Start Programs
U.S. Department of Health and Human Services
Administration for Children and Families
Office of Planning, Research and Evaluation
Child Outcomes Research and Evaluation
Administration on Children, Youth and Families
Head Start Bureau
Pathways to Quality and Full Implementation in
Early Head Start Programs
December 2002
Child Outcomes Research and Evaluation
Office of Planning, Research, and Evaluation
Administration for Children and Families
And the Head Start Bureau
Administration on Children, Youth and Families
Department of Health and Human Services
Early Head Start Evaluation Reports
Leading the Way: Describes the characteristics and implementation levels of 17 Early Head Start programs in fall
1997, soon after they began serving families.
Executive Summary (December 2000): Summarizes Volumes I, II, and III.
Volume I (December 1999): Cross-Site Perspectives—Describes the characteristics of Early Head Start research
programs in fall 1997, across 17 sites.
Volume II (December 1999): Program Profiles—Presents the stories of each of the Early Head Start research
programs.
Volume III (December 2000): Program Implementation—Describes and analyzes the extent to which the programs
fully implemented, as specified in the Revised Head Start Program Performance Standards, as of fall 1997.
Pathways to Quality and Full Implementation in Early Head Start (December 2002): Describes and analyzes the
characteristics, levels of implementation, and levels of quality of the 17 Early Head Start programs in fall 1999,
three years into serving families. Presents an analysis of the pathways programs followed to achieve full
implementation and high quality.
Building Their Futures: How Early Head Start Programs Are Enhancing the Lives of Infants and Toddlers in Low-
Income Families: Presents analysis of the impacts that the research programs have had on children’s
development, parenting, and family development through 2 years of age.
Summary Report (January 2001): Synopsis of the major findings.
Technical Report (June 2001): Detailed findings and report on methodology and analytic approaches.
Special Policy Report on Child Care in Early Head Start (December 2002): Describes the nature, types, and quality of
child care arrangements in which Early Head Start children enrolled, and presents findings on the impacts of Early
Head Start on both child care use and quality.
Special Policy Report on Children’s Health in Early Head Start (February 2003): Describes children’s health status
and health services received by Early Head Start and control group families.
Making a Difference in the Lives of Infants and Toddlers and Their Families: The Impacts of Early Head Start
(June 2002): Presents analysis of the impacts that the research programs have had on children’s development,
parenting, and family development through the children’s third birthday (including two to three years of program
participation).
Reports Are Available at:
http://www.acf.dhhs.gov/programs/core/ongoing_research/ehs/ehs_intro.html
http://www.mathematica-mpr.com/3rdLevel/ehstoc.htm
ii
Prepared for:
Rachel Chazan Cohen, Louisa Banks Tarullo, and Esther Kresh
Child Outcomes Research and Evaluation
Office of Planning, Research and Evaluation
Administration for Children and Families
U.S. Department of Health and Human Services
Washington, DC
Prepared by:
Mathematica Policy Research, Inc.
Princeton, NJ
Under Contract DHHS-105-95-1936
Authors:
Ellen Eliason Kisker
Diane Paulsell
John M. Love
Mathematica Policy Research, Inc.
Helen Raikes
Society for Research in Child Development Visiting Scholar
Administration for Children and Families
iii
CONTENTS
Chapter Page
EXECUTIVE SUMMARY......................................................................................... xxi
I THE FIRST FOUR YEARS OF EARLY HEAD START: ORIGINS
AND CONTEXT............................................................................................................ 1
A. THE EARLY HEAD START PROGRAM ............................................................ 5
1. Origins of the Early Head Start Initiative........................................................ 5
2. Early Head Start’s Social and Political Context.............................................. 8
3. Context of the Evolving Infrastructure of Program Support......................... 12
B. EARLY HEAD START RESEARCH AND EVALUATION PROJECT ........... 14
C. FAMILIES IN THE RESEARCH PROGRAMS ................................................. 17
D. DATA SOURCES AND METHODS FOR THE IMPLEMENTATION
STUDY.................................................................................................................. 20
D
1. ata Sources.................................................................................................. 22
2. Overview of Analytic Methods ..................................................................... 23
II PROGRAM DEVELOPMENT AND EVOLVING PROGRAM
APPROACHES ............................................................................................................ 25
A. THE CONTEXT FOR PROGRAM DEVELOPMENT ....................................... 28
B. SALIENT FEATURES OF EARLY HEAD START RESEARCH
PROGRAMS IN 1999 AND THEIR KEY DEVELOPMENTS OVER TIME ... 32
1. Center-Based Programs—that Remained Center-Based............................... 32
2. Home-Based Programs that Remained Home-Based.................................... 34
3. Mixed-Approach Programs that Remained Mixed ....................................... 37
4. Home-Based Programs that Became Mixed-Approach Programs ................ 43
C. THEMES OF CHANGE ....................................................................................... 46
D. SUMMARY .......................................................................................................... 49
v
CONTENTS (continued)
Chapter Page
III PROGRAMS’ THEORIES OF CHANGE AND THEIR EVOLUTION
OVER TIME ................................................................................................................ 51
A. INTRODUCTION................................................................................................. 51
B. EVOLUTION IN PROGRAMS’ EXPECTED OUTCOMES.............................. 61
1. Specific Changes That Occurred in Programs’ Focus on Priority
Outcomes in Particular Areas........................................................................ 61
2. Changes Across All Expected Outcomes Between 1997 and 1999............... 65
3. Summarizing Programs’ Expected Child and Family Outcomes.................. 66
4. The Relationship Among Expected Outcomes, Program Approaches,
and Program Impacts..................................................................................... 67
C. PERSPECTIVES FROM THEORY-OF-CHANGE DISCUSSIONS
AMONG RESEARCHERS AND PRACTITIONERS......................................... 72
1. The Value of Research-Program Partnership in Developing Theories of
Change........................................................................................................... 72
2. Voices of the Staff: Home Visitors Describe Their “Theories of
Change” ......................................................................................................... 73
3. Local Variations in the Development of Program Theories of Change ........ 73
D. SUMMARY .......................................................................................................... 78
IV PROGRAM IMPLEMENTATION: OVERALL LEVELS AND PATTERNS......... 81
A. MEASURING PROGRAM IMPLEMENTATION.............................................. 81
D
1. ata Sources.................................................................................................. 82
2. Implementation Rating Scales....................................................................... 82
3. Rating Process ............................................................................................... 86
B. PROGRESS IN OVERALL IMPLEMENTATION BETWEEN FALL 1997
AND FALL 1999 .................................................................................................. 87
C. PATTERNS IN THE TIMING BY WHICH PROGRAMS REACHED
OVERALL IMPLEMENTATION ....................................................................... 89
vi
CONTENTS (continued)
Chapter Page
V PROGRESS IN IMPLEMENTING KEY CHILD DEVELOPMENT AND
HEALTH SERVICES .................................................................................................. 95
A. DEVELOPMENTAL ASSESSMENTS ............................................................... 98
B. INDIVIDUALIZATION OF CHILD DEVELOPMENT SERVICES ................. 98
C. PARENT INVOLVEMENT IN CHILD DEVELOPMENT SERVICES .......... 101
D. GROUP SOCIALIZATIONS ............................................................................. 102
C
E. HILD CARE ..................................................................................................... 104
F. HEALTH SERVICES FOR CHILDREN ........................................................... 110
G. FREQUENCY OF CHILD DEVELOPMENT SERVICES ............................... 111
H. SERVICES FOR CHILDREN WITH DISABILITIES ...................................... 116
I. SUMMARY ........................................................................................................ 118
VI PROGRESS IN IMPLEMENTING FAMILY AND COMMUNITY
PARTNERSHIPS ....................................................................................................... 119
A. FAMILY PARTNERSHIPS: CHANGES IN SERVICES AND
IMPLEMENTATION PROGRESS BETWEEN 1997 AND 1999 .................... 120
1. Individualized Family Partnership Agreements .......................................... 121
2. Availability of Services ............................................................................... 121
3. Frequency of Services ................................................................................. 124
4.
Parent Involvement ..................................................................................... 124
B. COMMUNITY PARTNERSHIPS: CHANGES IN SERVICES AND
IMPLEMENTATION PROGRESS BETWEEN 1997 AND 1999 .................... 127
1.
Collaborative Relationships ........................................................................ 128
2.
Advisory Committees.................................................................................. 128
3.
Transition Planning ..................................................................................... 131
S
C. UMMARY ........................................................................................................ 131
vii
CONTENTS (continued)
Chapter Page
VII PROGRAM IMPLEMENTATION: STAFF DEVELOPMENT AND
PROGRAM MANAGEMENT .................................................................................. 133
A. EARLY HEAD START STAFF CHARACTERISTICS ................................... 135
B. STAFF DEVELOPMENT PRACTICES AND IMPLEMENTATION IN
1999 AND PROGRESS BETWEEN 1997 AND 1999 ...................................... 137
1.
Supervision.................................................................................................. 138
2.
Staff Retention............................................................................................. 138
3. Staff Training and Educational Attainment ................................................ 142
4.
Compensation.............................................................................................. 147
5.
Staff Morale................................................................................................. 153
6. Staff Health and Mental Health................................................................... 158
7. Job Satisfaction and Commitment............................................................... 160
C. IMPLEMENTATION OF MANAGEMENT SYSTEMS AND CHANGES
FROM 1997 TO 1999 ......................................................................................... 162
1. P
olicy Councils ........................................................................................... 162
2. Goals, Objectives, and Plans ....................................................................... 162
3.
Program Self-Assessment ........................................................................... 165
4. Community Needs Assessment ................................................................... 166
5.
Communications Systems ........................................................................... 166
D. SUMMARY ........................................................................................................ 167
VIII THE QUALITY OF SELECTED CHILD DEVELOPMENT SERVICES............... 169
A. METHODS FOR ASSESSING QUALITY........................................................ 169
1. Rating Inputs to Quality .............................................................................. 170
2. Observations of Child Care Quality ............................................................ 170
B. INPUTS TO CHILD CARE QUALITY............................................................. 172
C. OBSERVED CHILD CARE QUALITY ............................................................ 176
1. Quality in Early Head Start Centers ............................................................ 176
2. Observed Child Care Quality in Community Child Care Centers .............. 178
3. Observed Child Care Quality in Family Child Care Settings ..................... 182
viii
CONTENTS (continued)
Chapter Page
D. INPUTS TO THE QUALITY OF CHILD DEVELOPMENT HOME VISITS. 183
S
E. UMMARY ........................................................................................................ 186
IX PROGRAM PARTICIPATION AND FAMILIES’ SERVICE NEEDS AND
USE ............................................................................................................................ 187
A. DATA SOURCES............................................................................................... 187
B. INVOLVING FAMILIES IN SERVICES: LEVELS AND INTENSITY OF
PROGRAM PARTICIPATION.......................................................................... 189
1.
Overall Participation Levels........................................................................ 189
2.
Home Visits................................................................................................. 191
3.
Case Management ....................................................................................... 195
4. Parenting Information Services and Group Parenting Activities ................ 197
5. Child Care and Center-Based Child Development Services ....................... 201
6. Services for Children with Disabilities ....................................................... 210
7. Child Health Services.................................................................................. 212
8.
Family Health Services ............................................................................... 215
9. Other Family Development Services .......................................................... 215
E
C. NGAGEMENT IN SERVICES ........................................................................ 219
1. Local Research on Program Engagement ................................................... 224
2. Family Risk Factors and Program Participation ......................................... 225
D. THE MATCH BETWEEN FAMILIES’ EARLY NEEDS AND SERVICE
USE IN SPECIFIC AREAS................................................................................ 225
1. Summary of Needs ...................................................................................... 230
2. Match Between Needs and Services ........................................................... 233
S
E. UMMARY ........................................................................................................ 235
ix
CONTENTS (continued)
Chapter Page
X PATHWAYS TO IMPLEMENTATION AND QUALITY ...................................... 237
A. CHANGES IN APPROACH AND IMPLEMENTATION LEVELS OVER
TIME ................................................................................................................... 238
1. Evolution in Program Approaches .............................................................. 239
2. Progress in Overall Program Implementation Over Time........................... 239
B. THEMES CHARACTERIZING EARLY PROGRAM DEVELOPMENT ....... 241
1. Increased Attention to the Revised Head Start Program Performance
Standards ..................................................................................................... 241
2. Increased Service Intensity.......................................................................... 242
3. Increased Focus on Child Development...................................................... 242
4. Refocused Efforts to Improve Child Care Quality and Availability........... 243
5. Enhanced Participation in Program Services/Activities.............................. 243
6. Expansion of Services ................................................................................. 244
7. Evolution of Community Partnerships ........................................................ 244
8. Leadership Changes .................................................................................... 245
9. Staff Changes .............................................................................................. 245
10. Shift Toward Providing Training and Technical Assistance ...................... 246
S
C. TRATEGIES FOR CHANGE .......................................................................... 246
1. Using New Curricula and Assessment Tools .............................................. 246
2. Creating Early Head Start Child Care Centers............................................ 247
3. Developing New Approaches to Improving Quality in Community
Child Care Settings...................................................................................... 247
4. Creating Systems for Tracking Services More Effectively......................... 248
5. Ending Partnerships..................................................................................... 249
6. Forming New Partnerships and Strengthening Existing Ones .................... 249
7. Reorganizing or Creating New Staff Positions ........................................... 250
8. Hiring New Staff into Existing Positions.................................................... 250
9. Providing Intensive Staff Training .............................................................. 251
10. Strengthening Staff Supervision.................................................................. 252
11. Increasing Staff Salaries.............................................................................. 252
12. Seeking Additional Funding........................................................................ 252
D. PROGRAM EXPERIENCES INFLUENCING PATHWAYS .......................... 253
1. Conversion from Comprehensive Child Development Programs............... 253
2. Addition of Early Head Start to Head Start Programs ................................ 254
3. Community Programs Becoming Early Head Start Programs .................... 254
x
CONTENTS (continued)
Chapter Page
E. CHANGES IN THE POLICY AND PROGRAM CONTEXT .......................... 255
1. Revised Head Start Program Performance Standards ................................. 255
2. W
elfare Reform........................................................................................... 255
3. Changes in State Medicaid Programs.......................................................... 256
4. Local Child Care Markets ........................................................................... 256
F. SOURCES OF GUIDANCE RECEIVED BY EARLY HEAD START
PROGRAMS....................................................................................................... 257
G. CONCLUSIONS: MAJOR ACCOMPLISHMENTS AND REMAINING
CHALLENGES................................................................................................... 258
1. Noteworthy Accomplishments .................................................................... 258
2. Looking Ahead: Noteworthy Challenges ................................................... 260
3. Summary ..................................................................................................... 261
REFERENCES............................................................................................................ 263
APPENDIX A ............................................................................................................. A.1
APPENDIX B...............................................................................................................B.1
APPENDIX C...............................................................................................................C.1
xi
TABLES
Table Page
I.1 COMPARISON OF RESEARCH PROGRAMS AND WAVE I AND II
PROGRAMS ................................................................................................................ 16
I.2 KEY CHARACTERISTICS OF CHILDREN ENTERING THE EARLY HEAD
START RESEARCH PROGRAMS............................................................................. 18
I.3 KEY CHARACTERISTICS OF FAMILIES ENTERING THE EARLY HEAD
START RESEARCH PROGRAMS............................................................................. 19
I.4 FAMILY RESOURCES AND RECEIPT OF ASSISTANCE BY FAMILIES
ENTERING THE EARLY HEAD START RESEARCH PROGRAMS..................... 21
III.1 OVERVIEW OF KEY OUTCOMES IDENTIFIED BY PROGRAMS IN 1997
AND 1999..................................................................................................................... 53
III.2 EARLY HEAD START PROGRAMS’ PRIORITY OUTCOMES ............................ 62
III.3 EVOLVING PRIORITIES WITHIN THE CHILD DEVELOPMENT AREA:
NUMBER (AND PERCENT OF PROGRAMS IDENTIFYING EACH
ASPECT OF CHILD DEVELOPMENT AS A PRIORITY OUTCOME ................... 65
III.4 CLUSTERS OF PROGRAMS WITH PRIORITY OUTCOMES IN EACH
ASPECT OF CHILD AND FAMILY DEVELOPMENT............................................ 68
IV.1 PROGRAM ELEMENTS INCLUDED IN THE EARLY HEAD START
IMPLEMENTATION RATING SCALES—FALL 1999............................................ 84
IV.2 EARLY HEAD START IMPLEMENTATION RATING SCALE LEVELS............. 85
VII.1 PERCENTAGE OF EARLY HEAD START STAFF WITH PARTICULAR
CHARACTERISTICS FOR THE FULL SAMPLE AND BY PROGRAM
APPROACH IN 1997................................................................................................. 136
VII.2 EARLY HEAD START STAFF EDUCATIONAL ATTAINMENT AND
PARTICIPATION IN TRAINING, FOR THE FULL SAMPLE AND BY
PROGRAM APPROACH .......................................................................................... 145
VII.3 EARLY HEAD START STAFF COMPENSATION AND FRINGE
BENEFITS, FOR THE FULL SAMPLE AND BY PROGRAM APPROACH ........ 150
xiii
TABLES (continued)
Table Page
VII.4 PERCENTAGE OF EARLY HEAD START STAFF AGREEING OR
STRONGLY AGREEING WITH STATEMENTS REGARDING THEIR
PROGRAM’S WORKPLACE CLIMATE, FOR THE FULL SAMPLE AND
BY PROGRAM APPROACH.................................................................................... 155
VII.5 STAFF HEALTH AND MENTAL HEALTH: PERCENTAGE OF EARLY
HEAD START STAFF RESPONDING “YES” TO SURVEY STATEMENTS,
FOR THE FULL SAMPLE AND BY PROGRAM APPROACH............................. 159
VII.6 JOB SATISFACTION AND COMMITMENT: PERCENTAGE OF EARLY
HEAD START STAFF RESPONDING TO SURVEY STATEMENTS,
FOR THE FULL SAMPLE AND BY PROGRAM APPROACH............................ 161
VIII.1 EARLY HEAD START CHILD CARE QUALITY: AVERAGE ITERS AND
FDCRS SCORES BY PROGRAM ............................................................................ 177
VIII.2 EARLY HEAD START CHILD CARE QUALITY AVERAGE OBSERVED
NUMBER OF CHILDREN PER TEACHER ........................................................... 180
VIII.3 EARLY HEAD START CHILD CARE QUALITY AVERAGE OBSERVED
GROUP SIZE ............................................................................................................ 181
IX.1 RECEIPT OF KEY EARLY HEAD START SERVICES DURING THE
FIRST 16 MONTHS, FOR THE FULL SAMPLE AND KEY PROGRAM
SUBGROUPS............................................................................................................. 190
IX.2 RECEIPT OF EARLY HEAD START HOME VISITS BY PROGRAM
FAMILIES DURING THE FIRST 16 MONTHS, FOR THE FULL SAMPLE
AND KEY PROGRAM SUBGROUPS ..................................................................... 193
IX.3 RECEIPT OF EARLY HEAD START CASE MANAGEMENT BY
PROGRAM FAMILIES DURING FIRST 16 MONTHS, FOR THE FULL
SAMPLE AND KEY PROGRAM SUBGROUPS .................................................... 196
IX.4 RECEIPT OF PARENTING INFORMATION AND PARTICIPATION IN
EARLY HEAD START PARENT EDUCATION AND OTHER GROUP
ACTIVITIES BY PROGRAM FAMILIES DURING THE FIRST 16 MONTHS,
FOR THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS........................ 199
IX.5 RECEIPT OF CHILD CARE DURING THE FIRST 16 MONTHS, FOR
THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS................................. 202
IX.6 PRIMARY CHILD CARE ARRANGEMENTS USED BY PROGRAM
FAMILIES DURING FIRST 15 MONTHS, BY KEY PROGRAM
SUBGROUPS............................................................................................................. 204
xiv
TABLES (continued)
Table Page
IX.7 AVERAGE HOURS PER WEEK IN CHILD CARE DURING FIRST
15 MONTHS, BY PROGRAM APPROACH IN 1997.............................................. 206
IX.8 PROPORTION OF THE FOLLOW-UP PERIOD THAT CHILDREN
ATTENDED CHILD CARE DURING FIRST 16 MONTHS, BY PROGRAM
APPROACH IN 1997................................................................................................. 207
IX.9 OUT-OF-POCKET CHILD CARE COSTS DURING FIRST 15 MONTHS,
BY KEY PROGRAM SUBGROUPS ........................................................................ 209
IX.10 RECEIPT OF SERVICES FOR CHILDREN WITH DISABILITIES DURING
THE FIRST 16 MONTHS, FOR THE FULL SAMPLE AND KEY
PROGRAM SUBGROUPS ........................................................................................ 211
IX.11 RECEIPT OF CHILD HEALTH SERVICES BY PROGRAM FAMILIES
DURING FIRST 16 MONTHS, FOR THE FULL SAMPLE AND KEY
PROGRAM SUBGROUPS ........................................................................................ 213
IX.12 RECEIPT OF FAMILY HEALTH SERVICES BY PROGRAM FAMILIES
DURING THE FIRST 16 MONTHS, FOR THE FULL SAMPLE AND
KEY PROGRAM SUBGROUPS............................................................................... 216
IX.13 RECEIPT OF EDUCATION, EMPLOYMENT, AND TRANSPORTATION
SERVICES BY PROGRAM FAMILIES DURING THE FIRST 15 MONTHS,
FOR THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS........................ 218
IX.14 RECEIPT OF HOUSING ASSISTANCE BY PROGRAM FAMILIES
DURING THE FIRST 16 MONTHS, FOR THE FULL SAMPLE AND
KEY PROGRAM SUBGROUPS............................................................................... 220
IX.15 STAFF RATINGS OF PROGRAM ENGAGEMENT, FOR THE FULL
SAMPLE AND KEY PROGRAM SUBGROUPS .................................................... 222
IX.16 SELECTED NEEDS REPORTED BY PROGRAM FAMILIES AT BASELINE,
FOR THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS........................ 231
IX.17 MATCH BETWEEN SELECTED BASELINE NEEDS AND SERVICES
USED BY PROGRAM FAMILIES DURING THE FIRST 16 MONTHS ............... 234
xv
FIGURES
Figure Page
I.1 KEY EVENTS IN THE IMPLEMENTATION OF EARLY HEAD START............... 7
II.1 BASIC PROGRAM APPROACHES........................................................................... 27
II.2 COMPLEXITY OF PROGRAM “APPROACHES” ................................................... 29
III.1 VARIATION IN PROGRAM APPROACH AMONG PROGRAMS
WITH DIFFERENT PRIORITY OUTCOMES........................................................... 69
III.2 PRIORITY EXPECTED OUTCOMES BY PROGRAM APPROACH...................... 70
III.3 PRIORITY EXPECTED CHILD DEVELOPMENT OUTCOMES, BY
PROGRAM APPROACH ............................................................................................ 71
IV.1 EARLY HEAD START OVERALL IMPLEMENTATION RATINGS .................... 88
V.1 EARLY HEAD START CHILD DEVELOPMENT SERVICES
IMPLEMENTATION RATINGS ................................................................................ 97
V.2 TOOLS USED BY EARLY HEAD START RESEARCH PROGRAMS
TO ASSESS CHILDREN’S DEVELOPMENT .......................................................... 99
V.3 EARLY HEAD START CHILD DEVELOPMENT SERVICES ASPECTS
THAT WERE FULLY IMPLEMENTED.................................................................. 100
V.4 ESTIMATED PROPORTION OF FAMILIES USING CHILD CARE.................... 105
V.5 STRATEGIES USED BY EARLY HEAD START RESEARCH PROGRAMS
TO MEET THE PERFORMANCE STANDARDS FOR CHILD CARE ................. 107
V.6 FREQUENCY OF COMPLETED HOME VISITS IN EARLY HEAD START
RESEARCH PROGRAMS FOR FAMILIES RECEIVING HOME-BASED
SERVICES ................................................................................................................. 114
V.7 PERCENTAGE OF TIME TYPICALLY SPENT ON CHILD DEVELOPMENT
IN HOME VISITS ...................................................................................................... 115
V.8 STRATEGIES BEYOND HOME VISITING USED BY EARLY HEAD
START RESEARCH PROGRAMS TO PROVIDE PARENTING
EDUCATION ............................................................................................................. 117
xvii
FIGURES (continued)
Figure Page
VI.1 EARLY HEAD START FAMILY PARTNERSHIPS IMPLEMENTATION
RATINGS ................................................................................................................... 122
VI.2 EARLY HEAD START FAMILY PARTNERSHIPS ASPECTS THAT
WERE FULLY IMPLEMENTED ............................................................................. 123
VI.3 ACTIVITIES TO PROMOTE PARENT INVOLVEMENT ..................................... 126
VI.4 EARLY HEAD START COMMUNITY PARTNERSHIPS IMPLEMENTATION
RATINGS ................................................................................................................... 129
VI.5 EARLY HEAD START COMMUNITY PARTNERSHIPS ASPECTS THAT
WERE FULLY IMPLEMENTED ............................................................................. 130
VII.1 EARLY HEAD START STAFF DEVELOPMENT ACTIVITIES
IMPLEMENTATION RATINGS .............................................................................. 139
VII.2 EXTENT TO WHICH FIVE EARLY HEAD START STAFF DEVELOPMENT
ACTIVITIES WERE FULLY IMPLEMENTED ...................................................... 140
VII.3 FRINGE BENEFITS RECEIVED BY STAFF IN EARLY HEAD START
RESEARCH PROGRAMS, FALL 1997 AND FALL 1999...................................... 151
VII.4 WORKPLACE CLIMATE, FALL 1997 AND FALL 1999 ...................................... 154
VII.5 WORKPLACE CLIMATE: COLLABORATION, SHARING, AND
DECISION MAKING FALL 1997 AND FALL 1999............................................... 157
VII.6 EARLY HEAD START MANAGEMENT SYSTEMS IMPLEMENTATION
RATINGS ................................................................................................................... 163
VII.7 EARLY HEAD START MANAGEMENT SYSTEMS ASPECTS THAT
WERE FULLY IMPLEMENTED ............................................................................. 164
VIII.1 NUMBER OF PROGRAMS WITH CENTERS IN WHICH INPUTS TO
QUALITY WERE RATED AS GOOD OR HIGH.................................................... 173
VIII.2 EARLY HEAD START INPUTS TO CHILD CARE QUALITY THAT
WERE RATED GOOD OR HIGH FALL 1999......................................................... 175
VIII.3 EARLY HEAD START CENTERS AVERAGE ITERS SUBSCALE SCORES,
1998-99 ....................................................................................................................... 179
VIII.4 EARLY HEAD START CHILD DEVELOPMENT HOME VISITS:
OVERALL RATINGS OF QUALITY INPUTS ....................................................... 184
xviii
FIGURES (continued)
Figure Page
VIII.5 EARLY HEAD START CHILD DEVELOPMENT HOME VISITS:
RATINGS OF QUALITY INPUTS ........................................................................... 185
X.1 TIMELINE OF AN EARLY IMPLEMENTER........................................................ 240
xix
EXECUTIVE SUMMARY
To meet multiple purposes, the National Early Head Start Research and Evaluation project
included an implementation study, a study of program impacts through the children’s second and
third birthdays, continuous improvement feedback, local research, and special policy studies (on
such topics as child care, fathers, health and disabilities, and welfare reform). In addition,
longitudinal followup is under way as the children transition through Head Start and other
preschool programs and enter kindergarten. Implementation data were collected through three
rounds of site visits, surveys of program staff in fall 1997 and 1999, and observations in Early
Head Start and community centers. The implementation study tells the story of the programs’
development through their early years, examining the nature and extent of implementation in key
program areas and the quality of crucial child development services. The final report of the
implementation study, Pathways to Quality, describes lessons from the implementation analysis
of the experiences of the 17 research programs as they developed between their initial funding in
1995 or 1996 and the final site visits in fall 1999.1
MAJOR FINDINGS
Evolving Program Approaches. Program approaches to delivering services increased in
complexity over time. The research programs began about equally divided among center-based,
home-based, and mixed-approach strategies; by fall 1997, the home-based approach
predominated.2 By 1999, however, only two of the home-based programs were continuing in
that mode exclusively; the others had adopted a mixed approach. Four programs remained
center-based throughout this period.
Progress in Overall Implementation. One-third (6) of the programs were early
implementers, becoming fully implemented overall by fall 1997 and maintaining that level in late
1999, while still expanding the numbers of families served. By fall 1999, two-thirds (12) of the
programs were fully implemented, with six later implementers making significant progress
between 1997 and 1999. The remaining five programs were incomplete implementers, which did
1
The implementation study and its findings are fully described in two sets of reports. The first report, Leading
the Way (ACYF 1999a; 2000a; and 2000b), includes in-depth profiles of each of the 17 research programs (Volume
II), a detailed cross-site analysis of the program services being delivered (Volume I), and analysis of the levels of
implementation programs achieved and the quality of their child development services (Volume III) as of fall 1997.
Pathways to Quality applies some of these same analyses to the levels of implementation and quality observed in
1999, while tracing the dynamics of program changes that led to these achievements.
2
Center-based programs provide all services to families through the center-based option (center-based child
care, plus other activities) and offer a minimum of two home visits per year to each family; home-based programs
provide all services to families in the home-based option through weekly home visits and at least two group
socializations per month for each family; mixed-approach programs provide center-based services to some families,
home-based services to other families, or a mixture of center-based and home-based services to the same families.
xxi
not achieve ratings of “fully implemented” during the evaluation period, even though all made
strides in particular program areas and, in fact, showed a number of strengths.3
Variation in Implementation. The number of programs rated as fully implemented varied
across the domains of program operations. Fifteen programs achieved that level by 1999 in
community partnerships and in staff development, 14 in management systems, 12 in family
partnerships, and 9 in child development and health services. There was also considerable
variation within each of these areas.
Family Engagement. Program staff rated more than one-third of their families as being
highly engaged in program services. Based on the parents’ self-reports, programs that became
fully implemented early generally succeeded in delivering more frequent and intense services to
their families than the later-implemented or incompletely implemented programs.
Service Needs and Use. Most families who received services related to their reported needs
at enrollment began receiving them in the initial follow-up period. In child care and education,
some families who had a need at enrollment and did not receive services during the first follow-
up period began receiving services in the second follow-up period. By the second followup,
most families had received services related to the needs they expressed at enrollment. At least
85 percent of families who expressed a need in family health care, parenting information, child
care, and education reported receiving services they needed. Most families who expressed a
need for employment and housing reported receiving related services. However, fewer than half
of families with a need in transportation and services for children with disabilities received
services within the first 16 months after enrollment.
Quality of Child Development Services. Overall, the quality of both home- and center-
based child development services was good. On average, centers maintained teacher-child ratios
and group sizes that met the revised Head Start Program Performance Standards, and average
scores on the Infant-Toddler Environment Rating Scale were in the good-to-excellent range.4
Ratings of factors believed to influence home-visiting effectiveness (such as home visitor hiring,
training and supervision; planning and frequency of home visits; staff reports of child
development emphasis during home visits; and integration with other services) were “good” or
“high” quality in 9 of the 13 programs with home-based services in 1997, and increased to 11 in
1999.
3
In-depth site visits provided information for rating levels of implementation along key program elements
contained in the Early Head Start program announcement and the Head Start Program Performance Standards
(which were revised to encompass program serving infants and toddlers and took effect in 1998). Although the
implementation ratings designed for research purposes were not used to monitor compliance, they included criteria
on most of the dimensions that the Head Start Bureau uses in program monitoring, including child development and
health, family development, community building, staff development, and management systems. Being fully
implemented meant that programs achieved ratings of 4 or 5 on the 5-point scales used by the research team across
most of the elements rated. Programs that were not fully implemented overall had implemented some aspects of the
relevant program elements fully and had implemented other aspects, but not at the level required for a high rating.
Some of the incompletely implemented programs showed strengths in family development, community building, or
staff development.
4
A policy report examining child care use and child care quality in more detail will be released in mid-2002.
xxii
Staff Development and Management. Staff responses to the fall 1999 survey showed that
staff morale was generally high. Staff reported positive workplace climates and valued their
directors. Although most programs experienced annual turnover in the 15 to 32 percent range,
fewer programs experienced very high turnover rates in 1999 than were reported in 1997. A
number of programs focused on improving wages, with the average compensation for frontline
staff improved by 9 percent over that two-year period. By 1999, programs were successful
overall in meeting the performance standards requirement that at least 50 percent of frontline
staff have a two-year or higher degree—even before the 2003 deadline. However, center-based
programs had not yet achieved the required goal of having all teachers CDA-certified within a
year of being hired.
THEMES CHARACTERIZING EARLY STAGES OF PROGRAM DEVELOPMENT
Ten themes summarize the key experiences of these programs that were funded early in the
initiative. Although the circumstances of each program are unique, other programs may have
similar experiences as they progress toward fuller implementation and higher-quality services.
• Increased attention to the revised Head Start Program Performance Standards.
Ongoing guidance from the Head Start Bureau and technical assistance providers
helped programs interpret the performance standards. Head Start Bureau monitoring
visits between 1997 and 1999 clarified the standards and identified areas that
programs needed to change in order to comply with the standards, and motivated staff
to address these areas.
• Expanding services. Many programs expanded services to families, began serving
new neighborhoods, and/or increased the number of families served.
• Increasing service intensity. Most programs became more successful over time in
delivering more-intensive services to a higher proportion of families. Home-based
programs provided more-frequent home visits and group socializations; programs
operating centers increased the hours of operation.
• Increasing child development focus. Some programs began with a family support
focus, and over time increased the child development focus of services during home
visits by changing curricula and providing additional training and supervision.
• Refocusing efforts to improve child care quality. Several programs moved from
community-level, collaborative quality improvement activities to focusing on the
quality of the arrangements Early Head Start children were in. Programs developed
myriad activities to meet the challenge of improving child care quality, such as
developing partnerships with child care providers, offering training and technical
assistance to providers, and monitoring arrangements.
• Enhancing family participation in program services. To address the challenge of
involving families in services at the planned intensity, some programs made strong
efforts to increase family involvement in home visits and group socializations. Some
also focused on involving men in program activities.
xxiii
• Providing training and technical assistance. The research programs, among the
first wave of Early Head Start programs, were often called on to share their
experiences with newer programs in their region. Thus, several moved into a new
role of providing assistance to other programs.
• Evolving community partnerships. Changes such as increasing the child
development focus of services often meant that original partners were either less
appropriate or insufficient for meeting the needs of families. A number of programs
ended partnerships that were no longer necessary and/or formed new partnerships and
interagency collaborations, especially with Part C agencies and child care providers.
• Changing leadership. In most of the research programs, leadership did not change.
However, when changes did occur, they sometimes set back or stalled program
progress but sometimes created opportunities for positive change.
• Increasing complexity. Programs examined their service mix, adapted to changing
community circumstances and family needs, and learned from their experiences.
Expanding services, creating a better fit between services and family needs, and other
program developments (especially among those that became more “mixed” in their
approaches to serving families), typically increased the complexity of the service
approaches. Part of the complexity was often reflected in reorganized staffing
structures, intensified training plans, and searches for additional sources of funds
(such as state grants and child care subsidies).
LOOKING BACK: SELECTED ACCOMPLISHMENTS
The programs achieved many important successes over the first several years of
implementation. Looking back, several accomplishments stand out:
• Nearly three-quarters of the research programs became fully implemented.
Most programs were able to reach full implementation within four years of their
initial funding. The others made considerable progress in several program areas but
were not able to become fully implemented within the first four years.
• Implementation progress occurred even while program complexity increased
and program emphases changed over time. Programs often altered their basic
approaches to providing child development services to accommodate the changing
needs of families. The changes in approaches usually entailed adding service options
and offering their families a more complex set of options.
• The infrastructure to support Early Head Start grew alongside the programs.
During the study period, the training and technical-assistance system grew to
accommodate the rapidly expanding number of Early Head Start programs.
Programs often cited guidance received from Head Start Bureau monitors and
training and technical-assistance providers as key to their growth and development.
xxiv
• To a large extent, the programs delivered the required services. Programs
delivered child development and other services to families in centers, during home
visits and case management meetings, and in group parenting activities. Services
included child development services (child care, assessments and screening,
activities with children during home visits, and group socializations), parenting
education, and family development services (case management, health services, and
transportation assistance). Most families received the services that related to the
needs they expressed at the time they enrolled. The majority of families received
services at the required intensity during the first 16 months after enrollment. In
addition, 91 percent of parents, overall, met at least a minimal criterion for being
considered participants.
• The programs succeeded in providing more-intensive child development
services. Programs providing home visits increased the intensity of home visits from
two to three visits completed each month per family on average. Programs offering
center-based services all increased to full-day, full-year services, if they had not
offered these services initially.
• The Early Head Start centers provided good-quality care to infants and
toddlers, and initiated efforts to enhance quality in community child care
programs that Early Head Start children attended. Between the fall 1997 and
fall 1999 site visits, quality scores consistently averaged in the good-to-excellent
range. Several programs were rated as providing excellent care. Programs initiated
many efforts to enhance quality in community child care centers attended by Early
Head Start children.
• Attention to staff training, supervision, and support sustained high ratings of
staff satisfaction and commitment. Over time, many programs continued to refine
their training and supervisory approaches and support staff in providing consistent,
high-quality services to families. The research programs succeeded in creating
workplace environments that staff rated highly. Staff noted how much they had
learned by fall 1999 and expressed confidence that they now have a much clearer
idea of what they are trying to accomplish and how to go about it.
• Early Head Start programs contributed to their communities. In a number of
ways, maturing programs began making a difference for the larger communities in
which they are located. For example, they began increasing the number of infant and
toddler experts in their communities, contributing to greater integration of services in
the community, and establishing degree programs in early childhood development at
local colleges to augment community resources in early childhood.
• Community partnerships grew in number and effectiveness. Early Head Start
programs have become better known and more accepted in their communities.
Special Quest has played a key role in strengthening partnerships between Early Head
Start programs and Part C providers. In addition, more programs have contracts or
agreements with child care providers.
xxv
LOOKING AHEAD: IMPORTANT CHALLENGES
Looking beyond the Early Head Start research programs’ first four years of operation, we
see several challenges remaining. These challenges create opportunities for continued growth
and improvement in these 17 programs and provide lessons for all Early Head Start programs:
• Continuing to adjust to changing family needs. During their first four years, the
research programs adapted their services to family needs that changed as a result of
welfare reform. In many states, as families reach their time limits on cash assistance
and the economy weakens, programs may face new challenges as they help families
cope with these changes.
• Finding effective strategies for engaging families in parenting education and
group socializations. During their first four years, most of the research programs
providing home-based services to some or all families were unable to achieve high
participation rates in group socializations, and programs that were exclusively or
partially center-based continued to have difficulty engaging parents more fully in
parent education classes and support groups. Regardless of program approach,
programs need to continue to find effective ways of engaging families.
• Increasing father involvement. In searching for effective approaches to involving
parents in group socializations and parenting education, as well as in other program
activities, the programs may also discover creative ways to involve fathers.
• Ensuring that children’s child care arrangements meet the revised Head Start
Program Performance Standards. Programs that relied on community child care
settings to meet their families’ child care needs developed a range of strategies for
ensuring quality. However, most programs that are not center-based are challenged to
continue to build community child care partnerships to ensure quality child care for
all program children.
• Balancing program needs and the needs of staff. Programs’ staffing needs are
likely to continue changing as programs evolve and services change, which will
require programs to prepare staff for new responsibilities and sometimes to change
their staff structure. In this context, programs also must meet the financial and other
needs of a more professional workforce to minimize staff turnover.
Reaching full implementation quickly presents a significant challenge for some programs.
Achieving full implementation takes time, and not all programs will be successful within the first
three or four years of funding. All programs, and the infrastructure that supports them, need to
work together toward the goal of reaching full implementation as quickly as possible.
xxvi
I. THE FIRST FOUR YEARS OF EARLY HEAD START:
ORIGINS AND CONTEXT
The year 1995 saw the beginning of a new federal program, with 68 grantees, aimed at
enhancing the development of infants and toddlers. It was named Early Head Start by the
Secretary’s Advisory Committee on Services for Families with Infants and Toddlers that created
it. The program has grown into today’s national initiative, which comprises 664 grantees serving
some 55,000 children around the country, commands an increasing proportion of the Head Start
budget, and enjoys bipartisan support.1 Seventeen of these programs are participating in a
national evaluation and local research studies that are documenting the implementation process
and assessing program impacts and outcomes. The 17 research programs, which reflect
important characteristics of all 143 Early Head Start programs funded in the first two waves
(1995-1996 and 1996-1997; ACYF 1999a), were also among the first to design and implement
programs under the revised Head Start Program Performance Standards (U.S. Department of
Health and Human Services 1996). The 17 research programs opened their doors to the
implementation research to provide lessons that might apply to all Early Head Start programs
and ultimately aid program development for new Early Head Start programs across the country.
During their first four years, the research programs moved from designing services and
enrolling children and families to making real the vision of the Advisory Committee on Services
for Families with Infants and Toddlers (U.S. Department of Health and Human Services 1995).
The developments during this period were dramatic. Programs exerted strong efforts to create
1
At the October 23, 1997, White House Conference on Child Care, the President announced
his proposal to double Early Head Start funding; Congress has increased Early Head Start’s share
of the Head Start budget from 3 percent in fiscal year 1995 to 10 percent in 2001 and 2002.
1
the appropriate services for their families. They made numerous changes to meet the revised
performance standards that were announced in late 1996 and went into effect January 1, 1998
(U.S. Department of Health and Human Services 1996). In some cases, this meant fine-tuning
their mix of services to fit both the program vision (with its accompanying standards and
guidelines) and the needs of their families and communities. In other cases, meeting the
changing needs of families moving from welfare to work meant redesigning programs developed
for a world before welfare reform. In still other cases, programs looked beyond their immediate
boundaries to take on the mantle of leadership for local and statewide partnerships to enhance
services for infants and toddlers. Through these and many other experiences described in this
report, the research programs provide an invaluable opportunity to learn about what it takes to
make the Early Head Start concept functional within a changing programmatic and policy
context.
Pathways to Quality describes the programs as they existed in fall 1999 and tells the story of
their development during the first three to four years of operation.2 This report describes their
programmatic approaches in 1999, follows their evolution since 1997, and describes the paths
they followed from their early beginnings. What emerges is a picture of a dynamic process
through which 17 programs serving diverse communities found varied ways to achieve new and
increasing levels of implementation and quality in their key program services. This picture
comes into focus in succeeding chapters as we address the following research questions:
• How have the programs changed over time? How have they grown during their first
four years? What is the story of their dynamic change and growth?
2
One of the research sites was a Wave II program (funded in 1996-1997) and had only been
in operation for three years when we visited in 1999. As Wave I programs (funded in 1995
1996), all of the other research sites had been in operation for four years by the time of the 1999
site visits.
2
• To what extent did the Early Head Start research programs reach full implementation
within four years after funding? To what extent did they achieve good quality in their
child development services?
• What does it take to attain full implementation and high quality services? How long
does it take? What are alternative trajectories to achieving good quality?
• What factors account for the variation in levels of implementation and quality among
the research programs four years after funding?
• What are the key factors that facilitated the achievement of full implementation and
high quality? What key challenges did programs face in working toward these
goals?
To address these broad questions, we examined five aspects of the research programs’
development in depth: (1) their approach to delivering services, (2) their theories of change, (3)
the extent to which they fully implemented the Early Head Start program, (4) the quality of key
child development services, and (5) families’ levels of service use and program engagement.
These analyses provide an enriched understanding of implementation processes by enabling us to
chart implementation progress over time, discern trends in the way programs have grown and
changed, and identify key implementation challenges and successes.
The implementation study findings have also contributed to our understanding of program
impacts and outcomes. In addition to helping us interpret impact findings, we used the results of
our implementation analyses to test hypotheses about how various aspects of implementation
relate to outcomes. For example, how do program approach and the timing of program
implementation relate to child and family outcomes? To answer such questions, we designed
targeted impact analyses on key subgroups of programs.3 For example, we estimated impacts on
3
See Building Their Futures: How Early Head Start Programs Are Enhancing the Lives of
Infants and Toddlers in Low-Income Families (Administration on Children, Youth and Families
2001) and Making a Difference in the Lives of Infants and Toddlers and Their Families: The
Impacts of Early Head Start (Administration for Children and Families 2002) for more
information about targeted impact analyses conducted for specific subgroups of programs.
3
child and family outcomes for programs that implemented key aspects of the Head Start Program
Performance Standards early and later and for programs that implemented various approaches to
service delivery.
Pathway to Quality presents the detailed results of these implementation analyses and
highlights key implications for programs and policy. Chapter II identifies the main approaches
programs took to delivering services and traces the evolution of approaches to service delivery
over the first four years of operation. Chapter III explores the programs’ theories of change and
expected outcomes, focusing on how they changed during the evaluation period. Chapters IV
through VII present the results of our assessment of implementation: Chapter IV presents an
overview of the patterns and levels of program implementation overall; Chapter V focuses on
programs’ progress in implementing key child development services; Chapter VI examines
implementation of family and community partnerships; and Chapter VII describes progress in
implementing key aspects of staff development and program management systems. In Chapter
VIII, we focus on the quality of key child development services that programs achieved. Chapter
IX reports families’ use of services and the program engagement patterns of their families and
assesses the match between their service needs and service receipt. Finally, in Chapter X, we
analyze the pathways programs followed in striving to achieve full implementation and high
quality and the factors that influenced those pathways.
The rest of this introductory chapter provides an overview of the Early Head Start program
and the Early Head Start Research and Evaluation Project, summarizes key characteristics of
program families participating in the research, and describes the data sources and analytic
methods used for the implementation study.
4
A. THE EARLY HEAD START PROGRAM
1. Origins of the Early Head Start Initiative
Early Head Start began at a time of increasing awareness of the “quiet crisis” facing families
with infants and toddlers in the United States, as identified in a report entitled Starting Points:
Meeting the Needs of Our Youngest Children, by the Carnegie Corporation of New York (1994).
As the report showed, a great many infants and toddlers are starting life in poor environments,
without adequate stimulation, and without sufficient interactions with caring, responsive adults.
The release of Starting Points followed closely on a comprehensive self-examination of Head
Start services conducted by the Advisory Committee on Head Start Quality and Expansion. This
committee called for Head Start programs to improve their quality, address the fragmentation of
services by forging new partnerships, and expand services in a number of ways, including
serving more families with infants and toddlers (U.S. Department of Health and Human Services
1993). Subsequently, the Head Start Authorization Act of 1994 mandated new Head Start
services for families with infants and toddlers, authorizing 3 percent of the total Head Start
budget in fiscal year 1995, 4 percent in 1996 and 1997, and 5 percent in 1998 for these services
(U.S. Department of Health and Human Services 1994a). The Coats Human Services
Reauthorization Act of 1998 further expanded the program, setting aside 7.5 percent of Head
Start funds in 1999, 8 percent in 2000, and 10 percent in 2001 and 2002 for Early Head Start
programs (U.S. Department of Health and Human Services 1998).
In 1994, the Advisory Committee on Services for Families with Infants and Toddlers
provided guidelines for the new Early Head Start program. The report of the Advisory
Committee set forth a vision and blueprint for Early Head Start programs and established
principles and “cornerstones” for the new program (U.S. Department of Health and Human
Services 1994b).
5
Early Head Start programs are comprehensive child development programs. The Advisory
Committee on Services for Families with Infants and Toddlers envisioned a two-generation
program of intensive services that begin before the child is born and concentrate on enhancing
the child’s development and supporting the family during the critical first three years of the
child’s life. The Advisory Committee recommended that programs be designed to promote
outcomes in four domains:
• Child development (including health; resiliency; and social, cognitive, and language
development)
• Family development (including parenting and relationships with children, the home
environment and family functioning, family health, parent involvement, and
economic self-sufficiency)
• Staff development (including professional development and relationships with
parents)
• Community development (including enhanced child care quality, community
collaboration, and integration of services to support families with young children)
The program guidelines specify that grantees should design programs that achieve these
outcomes by providing home- or center-based child development services, combining these
approaches, or implementing other locally designed options.
The first wave of grantees—68 programs—was funded in September 1995. Another 75
programs were funded in September 1996, and in subsequent years additional funding brought
the total in 2002 to almost 700 programs serving some 60,000 infants and toddlers and their
families. Not only have the programs’ development been dramatic, it has taken place within a
changing context. National, state, and local changes in social policy (as well as changes in our
understanding of the effectiveness of child development programs), have dramatically influenced
the development of the programs and are likely to affect their future direction. Figure I.1 shows
the timing of the key events in the first five years of Early Head Start’s development. Important
6
FIGURE I.1
KEY EVENTS IN THE IMPLEMENTATION OF EARLY HEAD START
Advisory Committee on Head Start Quality and Expansion
Jan. 1994
recommended serving families with children under 3
Carnegie “Starting Points” report released
Head Start reauthorized with mandate to serve infants and toddlers
Advisory Committee set forth vision and named Early Head Start (EHS)
Jan. 1995
First EHS program announcement
Federal Fatherhood Initiative formed
Wave I: 68 new EHS programs funded
Jan. 1996
University-based research partners selected
First EHS programs began serving families
Welfare reform legislation enacted
Wave II: 75 new EHS programs funded
First round of research site visits conducted
Revised Head Start Performance Standards enacted
Jan. 1997
White House Conference on Early Childhood Development and
Learning
Wave III: 32 new EHS programs funded
Second round of research site visits conducted
Jan. 1998 Revised Head Start Performance Standards took effect
Monitoring visits to Wave I programs conducted
Wave IV: 127 new EHS programs funded
Wave V: 148 new EHS programs funded
Head Start reauthorized
Jan. 1999
Wave VI: 97 new EHS programs funded
Third round of research site visits conducted
Jan. 2000
7
events and changes within the Head Start/Early Head Start infrastructure have also shaped the
programs, including the revision of performance standards, ongoing program monitoring, and the
continuing training and technical assistance that supports Early Head Start programs.
2. Early Head Start’s Social and Political Context
Understanding the implementation of any large-scale initiative requires examining the
context in which it operates. Early Head Start is being implemented during a time of
fundamental changes in this country’s social services systems. Some of these changes may have
a dramatic effect on the approaches programs take, the ways in which families respond, and the
ways in which programs interact with others in their communities. In particular, five broad
social changes and contextual factors, some of which occurred after Early Head Start began, may
have influenced the Early Head Start initiative: (1) increasing recognition of the importance of
early development, (2) welfare reform in the context of a strong economy, (3) new child care and
prekindergarten initiatives, (4) growing attention to the roles of fathers in young children’s lives,
and (5) recent evaluation findings that identify challenges in improving outcomes for children
and families.
Early Child Development. Recent research has shown that human development before
birth and during the first year of life is rapid and extensive but vulnerable to environmental
influences (Shonkoff and Phillips 2000). Moreover, early development has a long-lasting effect
on children’s cognitive, behavioral, and physical growth (Carnegie Corporation of New York
1994). National attention focused on early brain development in spring 1997, when the White
House convened the Conference on Early Childhood Development and Learning and special
editions of national news magazines featured articles on the brain development of infants. All
this has helped program staff gain the support of policymakers, program sponsors, and
8
community members for services that start when women are pregnant and focus directly on child
development.
Welfare Reform. The Personal Responsibility and Work Opportunity Reconciliation Act of
1996 (PRWORA), which went into effect just as Early Head Start programs began serving
families, reformed federal welfare policy and gave states more autonomy and responsibility for
setting and administering welfare policy. It also established clear expectations for families
receiving welfare. Cash assistance is now provided through the Temporary Assistance for Needy
Families (TANF) program and is no longer an entitlement. Adults may receive cash assistance
for a maximum of 60 months over their lifetime. After two years (or less, at state option), many
families have to work in order to continue receiving cash assistance. Some states exempt parents
of infants from the work requirements for a short time (typically less than a year), but almost half
do not.
For delivery of program services, PRWORA created a climate different from the one that
existed when the first wave of Early Head Start grantees wrote their proposals. The new work
requirements and time limits on cash assistance have increased demands on parents’ time,
increased their child care needs, increased stress for some families, and made it more difficult for
parents to participate in some program services. Some parents are now more receptive to
services related to both employment and child care and are motivated to find jobs and work
toward self-sufficiency. Thus, in the context of the strong U.S. economy at that time, the new
requirements may have improved families’ economic well-being. The increasing need for good
infant/toddler child care has put extra pressure on Early Head Start programs either to provide
full-day, full-year child care themselves or to help develop and support it in their communities.
As discussed more fully in Chapter II, these changes caused some Early Head Start programs to
redesign their services to meet families’ current needs.
9
New Child Care and Prekindergarten Initiatives. PRWORA also consolidated federal
funding for child care into the Child Care and Development Fund (CCDF), which provides
increased funding for child care for low-income families and allows states to design
comprehensive, integrated child care subsidy systems. These changes may make it easier both
for families who need child care to obtain financial assistance and for Early Head Start staff
members to help them obtain child care subsidies. The increased employment of low-income
families under PRWORA has also increased the need for Early Head Start staff members to
collaborate with state child care administrators and local providers to help meet families’ child
care needs. Staff members have had to find ways to blend funds and work with the child care
system within their states and communities.
States are required to spend at least 4 percent of their total CCDF funds to improve quality
and expand supply of child care for infants and toddlers. In FY 1999, CCDF received an
additional $173 million to improve care specifically for these age groups. Since 1996, several
states in which Early Head Start research programs are located have used quality enhancement
funds to create new and stronger initiatives for infant-toddler child care: (1) in 1998, the Kansas
Legislature approved an Early Head Start project as a joint endeavor with the federal
government, and awarded grants to 13 early childhood development programs across the state;
(2) New York State increased funding for child care from its TANF funds and created an
incentive program for centers that serve infants and toddlers to seek accreditation; (3) Missouri
has been experimenting with differential reimbursement rates for infant and toddler care; and (4)
Michigan provides grants to encourage expansion and quality improvement, with special
attention given to programs for infants and toddlers (Blank, Behr, and Schulman 2001).
In addition to providing child care subsidies for low-income families, 42 states now fund
prekindergarten programs or have a school-funding mechanism for 4-year-olds (Mitchell 2001).
10
Shifting resources and increased support for the care of preschool children in many areas may
offer Head Start and other preschool programs more opportunities to blend funding sources and
may free resources for serving more families with infants and toddlers. Where early childhood
labor markets are tight, however, these initiatives have made it more difficult for Early Head
Start programs to hire and retain well-trained staff.
The Role of Fathers. During the study period, policymakers, researchers, and educators
have gained increasing appreciation of the importance of fathers as contributors of emotional and
economic support to their children. As a consequence, to promote the positive involvement of
fathers in the lives of their children, federal agencies were developing and enhancing fatherhood
policies. In addition to recent social trends and PRWORA’s increased emphasis on paternity
establishment and enforcement of child support judgments, the federal Fatherhood Initiative was
created in 1995 to promote the involvement of fathers and acknowledge their contributions to
their children’s well-being. The growing focus on fathers has led some programs to devote more
program resources than originally planned to strengthening fathers’ relationships with their
children and enhancing their parenting skills. Changing patterns of father involvement also
challenge programs to develop creative strategies that are not limited by traditional conceptions
of family structure.
Recent Program Evaluation Findings. The Early Head Start programs began just as new
findings from evaluations of programs that served families with infants and toddlers during the
1980s and early 1990s were being released. In particular, the longer-term findings of the
evaluation of ACYF’s Comprehensive Child Development Program (CCDP) were released soon
after the first Early Head Start programs were funded (St. Pierre et al. 1997). The CCDP, which
offered case management services to low-income families with infants and toddlers, had few
lasting impacts on child and family outcomes. In addition, recent research suggests that home
11
visiting programs often may not be effective and that careful attention needs to be paid to how
they are implemented (Gomby, Culross, and Behrman 1999; and Olds et al. 1998).
These recent research findings highlight the difficulty of improving the lives of low-income
children and families, but they also provide valuable lessons to build on.4 Research suggests that
programs that provide intensive, purposeful, high-quality, child-focused services are more likely
than those that provide primarily adult-focused services to effect significant changes in
children’s cognitive, social, and emotional development. Accordingly, ACYF directed Early
Head Start programs to emphasize child development services—direct services to children in
child development centers or home visits—and to pay careful attention to the quality of
children’s child care arrangements, in addition to supporting parents as their children’s primary
educators. ACYF strongly supports continuous program improvement in Early Head Start by
enforcing requirements in the revised Head Start Program Performance Standards for goal
setting, data collection, feedback, and formal self-assessment procedures; providing intensive
training and technical assistance; drawing on early research findings in its training and technical
assistance activities; and supporting program partnerships with local researchers.
3. Context of the Evolving Infrastructure of Program Support
Building on a national and regional infrastructure developed for the national Head Start
program, ACYF created for the Early Head Start programs an infrastructure that included (1) the
revised Head Start Program Performance Standards, (2) program monitoring to ensure
compliance with the standards, and (3) training and technical assistance to support programs in
achieving full implementation and quality.
4
For a summary of findings of key studies, see Chapter I of Making a Difference in the Lives
of Infants and Toddlers and Their Families: The Impacts of Early Head Start (ACYF 2002).
12
Early Head Start programs follow the Head Start Program Performance Standards and are
monitored according to their adherence to them. These standards were revised in 1996 through
an extensive process that took several years and included commentary by thousands of experts in
early education, health, and related areas; Head Start parents and staff members; and members of
the general public. At the time of site visits to the Early Head Start research programs in fall
1997 (described in Section D), the revised standards had been published but had not yet taken
effect, and the programs were still seeking clarification of some of the new regulations. The
revised performance standards took effect in January 1998.
Head Start Bureau monitoring teams visit programs every three years to check compliance
with program guidelines and the revised Head Start Program Performance Standards. Initially,
the national office of the Head Start Bureau was responsible for awarding program grants and
overseeing program operations. In fall 1997, however, this responsibility was transferred to the
10 U.S. Department of Health and Human Services Regional Offices, except for a limited
number of programs involving special circumstances. Wave I Early Head Start programs were
first monitored in spring 1998.
The Early Head Start National Resource Center was created in 1995 to provide ongoing
support, training, and technical assistance to all waves of Early Head Start programs under a
contract with ZERO TO THREE. The center has provided training conferences for Early Head
Start teachers known as “intensives” in infant-toddler care; week-long training for key program
staff; annual institutes in Washington, DC, for key program staff; and identification and
preparation of a cadre of nationally known infant-toddler consultants who work intensively with
programs on a one-to-one basis. The Early Head Start National Resource Center has worked
closely with regional training grantees—the Head Start Quality Improvement Centers (HSQICs)
and the Head Start Disabilities Quality Improvement Centers (DSQICs)—and with their infant
13
toddler specialists, as well as the 10 U.S. Department of Health and Human Services Regional
Offices and Indian and Migrant program branches that assumed responsibility for administrating
Early Head Start grants in fiscal year 1998.
B. EARLY HEAD START RESEARCH AND EVALUATION PROJECT
The Early Head Start Research and Evaluation Project includes a national evaluation
conducted in tandem with local research studies, which together address a broad range of issues.
The project is assessing program impacts on an extensive set of child and family outcomes. In
addition, it is investigating the role of program and contextual variations, studying the pathways
to achieving program quality, examining the pathways to desired child and family outcomes, and
creating the foundation for a series of longitudinal research studies.
To achieve its aims, the Early Head Start Research and Evaluation Project encompasses five
major components:
1. An implementation study to examine service needs and use for low-income
families with infants and toddlers, assess program implementation, understand
programs’ theories of change, illuminate pathways to achieving quality, and
identify and explore variations across sites
2. An impact evaluation, using an experimental design, to analyze the effects of
Early Head Start programs on children, parents, and families; and descriptive
analyses to assess outcomes for program staff and communities. Early Head Start
programs that are participating in the national evaluation recruited 150 to 200
families with pregnant women or children under age 1 to participate in the impact
evaluation (half the 3,000 children and families were randomly selected to
participate in the program, and half were randomly assigned to the control group)
3. Local research studies to learn more about the pathways to desired outcomes for
infants and toddlers, parents and families, staff, and communities
4. Policy studies to respond to information needs in areas of emerging policy-relevant
issues, including welfare reform, fatherhood, child care, health, and disabilities
5. Continuous program improvement activities to guide all Early Head Start
programs through formative evaluation
14
In 1996 and early 1997, ACYF selected 17 programs to participate in the national research
and evaluation project. When they first applied for funds, all Early Head Start programs funded
in Wave I (1995-1996) and Wave II (1996-1997) had agreed to participate in a random
assignment evaluation if they were selected. In January 1996, ACYF invited Wave I programs
to select local research partners and apply to be a research site for the national evaluation. To be
eligible, programs had to guarantee that they could recruit 150 families for Early Head Start
research (twice their program capacity). For easier identification of research partners, the
Society for Research in Child Development made directories of its membership available to each
new Early Head Start program, and ACYF issued a request for proposals, including the addresses
and contact persons for the 68 Wave I programs, to notify researchers of the research
opportunity. Forty-one program-researcher partnerships submitted proposals to be research sites
(a number of other programs may have been interested but could not meet the sample size
requirement). Initially, ACYF selected 15 partnerships, basing its choices on both the quality of
the proposed local research and a desire to achieve a balance across programs in national
geographic representation, rural and urban locations, racial/ethnic composition of families, and
program approaches. The 15, however, underrepresented center-based programs, so in 1996
ACYF selected one additional center-based program from Wave I, and in late 1997 selected
another center-based program (without a local research partner) from Wave II.
The final set of 17 research programs constitutes a balanced group that includes variation in
the key characteristics considered in the site-selection process. All the major program
approaches, family background characteristics, regions of the country, urban and rural areas, and
families’ racial/ethnic backgrounds are represented. Together, the selected programs also
broadly resemble all Early Head Start programs funded in the first two waves (Table I.1). They
have approximately the same ACYF-funded enrollment, on average, and the characteristics of
15
TABLE I.1
COMPARISON OF RESEARCH PROGRAMS AND WAVE I AND II PROGRAMS
Wave I Programs Wave II Programs Research Programs
(Percent) (Percent) (Percent)
Total ACYF-Funded Enrollment
10 to 29 children 6 0 0a
30 to 59 children 14 9 6
60 to 98 children 62 64 65
100 to 199 children 15 27 29
200 to 299 children 3 0 0
(Average) (81) (84) (85)
Race/Ethnicity of Enrolled Children
African American 33 21 34a
Hispanic 22 27 23
White 39 46 37
Other 6 5 6
English Is the Main Language 85 79 80
Family Type
Two-parent families 39 46 40
Single-parent families 51 46 52
Other relativesb 7 5 3
Foster families 1 1 0
Other 1 1 5
Employment Statusc
In school or training 20 22 22
Not employed 48 48 56
Number of Programs 66 11 17
SOURCE: Preliminary Head Start Family Information System application and enrollment data.
NOTE: The percentages for the Wave I and II Early Head Start programs are derived from available Program
Information Report (PIR) data. The percentages for the Early Head Start research programs are derived
from preliminary Head Start Family Information System application and enrollment data from 1,462
families.
Percentages may not add up to 100, as a result of rounding.
a
The data for the research programs refer to families instead of children.
b
The HSFIS data elements and definitions manual instructs programs to mark “other relatives” if the child is being
raised by relatives other than his/her parents, such as grandparents, aunts, or uncles, but not if the child is being
raised by his/her parents, and is living with other relatives as well.
c
The research program data and PIR data are not consistent in the way that they count primary caregivers’
employment status, so it is not possible to compare the percentage of caregivers who are employed.
16
enrolled children and families are very similar. Thus, although this sample of programs is not
statistically representative of all Early Head Start programs, the implementation study findings
from these programs are likely to be indicative of implementation issues faced more broadly
across all early programs (see Leading the Way, Volume I, Chapter II, for details; ACYF 1999a).
C. FAMILIES IN THE RESEARCH PROGRAMS
The families who enrolled in the Early Head Start research programs and in the research
study (those who enrolled between July 1996 and September 1998) had diverse characteristics
and needs when they enrolled:
• Most families enrolled in the research programs before their child reached the age of
6 months (Table I.2). One-fourth of the primary caregivers enrolled while they were
still pregnant (Table I.3).
• Indicators based on children’s low birthweight and reports by primary caregivers that
someone had a concern about their children’s development suggest that
approximately 20 percent of the children who enrolled after birth might have had or
were at risk for a developmental disability.5
• Many families included two parents—about 40 percent overall—but the extent to
which the research programs served two-parent families varied widely.
• About one-third of the children’s primary caregivers were teenage parents, but this
also varied substantially. For example, in two programs, more than half of all
families were headed by a teenage parent.
• On average, about one-third of the families were African American, one-fourth were
Hispanic, slightly more than one-third were white, and a small proportion belonged to
other groups. In 11 programs, enrolled families belonged predominantly to one
group, while in six programs, the racial/ethnic composition of enrolled families was
diverse and not dominated by one group.
5
Four percent of children who enrolled after birth had been born at low birthweight, and
concerns about their development were reported on the application form. Nine percent of the
children had not been born at low birthweight, but their primary caregivers reported that
someone had a concern about their development. Seven percent had been born at low
birthweight, but their primary caregivers did not report that someone had a concern about their
development. Children with these indicators at enrollment were not necessarily identified as
having disabilities within the evaluation period.
17
TABLE I.2
KEY CHARACTERISTICS OF CHILDREN ENTERING THE EARLY HEAD START
RESEARCH PROGRAMS
All Research
Programs Range Across
Combined Research Programs
(Percent) (Percent)
Child’s Age
Unborn 25 7 to 67
0 to 6 months old 42 12 to 57
6 to 12 months old 33 1 to 75
Child Was Born at Low Birthweight (Under
2,500 grams) 10 4 to 23
Concerns About Child’s Development Were
Noted on Application Form 13 3 to 26
Number of Applicants/Programs 1,514 17
SOURCE: Preliminary Head Start Family Information System application and enrollment data.
18
TABLE I.3
KEY CHARACTERISTICS OF FAMILIES ENTERING THE EARLY HEAD START
RESEARCH PROGRAMS
All Research
Programs Range Across
Combined Research Programs
(Percent) (Percent)
Primary Caregiver (Applicant) Is Female 94 88 to 99
Primary Caregiver Is a Teenager (under 20) 35 12 to 84
Primary Caregiver Is Married 28 2 to 70
Family Is a Two-Parent Family 40 9 to 74
Primary Caregiver�s Race/Ethnicity
African American 33 0 to 89
Hispanic 24 0 to 89
White 37 2 to 91
Other 6 0 to 16
Primary Caregiver�s Main Language Is Not
English 21 0 to 81
Primary Caregiver Does Not Speak English
Well 11 0 to 55
Primary Caregiver Lacks a High School
Diploma 48 24 to 88
Primary Caregiver�s Main Activity
Employed 23 11 to 44
In school or training 22 4 to 64
Unemployed 29 13 to 43
Other 26 2 to 55
Number of Applicants/Programs 1,514 17
SOURCE: Preliminary Head Start Family Information System application and enrollment data.
19
• On average, 20 percent of primary caregivers did not speak English as their main
language. Some of these caregivers also spoke English well, but some did not.
Overall, 11 percent of the primary caregivers did not speak English well.
• Overall, slightly more than half the primary caregivers had a high school diploma.
• On average, 23 percent of applicants were employed and another 22 percent were in
school or training (usually school) as their main occupation at the time they enrolled.
• Some of the families had basic needs that were not being met when they enrolled in
the research programs. Overall, the percentages reporting that they did not have
adequate food, housing, medical care, or personal support ranged from 5 to 13 percent
(Table I.4).
• Child care was a significant need of the families. Overall, 34 percent of the families
did not have adequate child care arrangements when they enrolled. The percentage of
families without adequate child care arrangements ranged from 8 to 66 percent across
the research programs.
• Most of the families who enrolled in the research programs were receiving some kind
of public assistance. Overall, 77 percent had Medicaid coverage, and 88 percent were
receiving WIC benefits. Almost half the families were receiving food stamps, and
slightly more than one-third were receiving AFDC or TANF cash assistance (some
pregnant women were not eligible for cash assistance because they were not yet
parents). A small proportion (7 percent) was receiving SSI benefits.
• Child care was a significant need of the families. Overall, 34 percent of the families
reported that their child care arrangements seldom or never met their needs, at the
time they enrolled. The percentage of families without adequate child care
arrangements ranged from 8 to 66 percent across the research programs.
• Most of the families who enrolled in the research programs were receiving some kind
of public assistance. Overall, 77 percent had Medicaid coverage, and 88 percent were
receiving WIC benefits. Almost half the families were receiving food stamps, and
slightly more than one-third were receiving AFDC or TANF cash assistance (some
pregnant women were not eligible for cash assistance because they were not yet
parents). A small proportion (7 percent) was receiving SSI benefits.
D. DATA SOURCES AND METHODS FOR THE IMPLEMENTATION STUDY
This report describes the 17 research programs as they existed in fall 1999 and focuses on
the changes that developed in their features over their first four years of operation, with special
emphasis on those that occurred between 1997 and 1999. Pathways to Quality builds on an
20
TABLE I.4
FAMILY RESOURCES AND RECEIPT OF ASSISTANCE BY FAMILIES ENTERING
THE EARLY HEAD START RESEARCH PROGRAMS
All Research Range Across Research
Programs Combined Programs
(Percent) (Percent)
Adequacy of Resources
Inadequate food 5 0 to 20
Inadequate housing 12 4 to 24
Inadequate medical care 14 3 to 36
Inadequate child care 35 11 to 67
Inadequate transportation 21 12 to 35
Inadequate parenting information 13 0 to 39
Inadequate personal support 13 3 to 39
Assistance Received Currently
Medicaid 77 47 to 89
AFDC/TANF 34 11 to 64
Food stamps 48 22 to 75
WIC 87 69 to 96
SSI 7 0 to 16
Number of Applicants/Programs 1,514 17
SOURCE: Preliminary Head Start Family Information System application and enrollment data.
21
earlier report that fully described the programs in their first year of serving families. That report,
Leading the Way, included in-depth profiles of each of the 17 research programs (Volume II), a
detailed cross-site analysis of the program services being delivered (Volume I), and analysis of
the levels of implementation programs achieved and the quality of their child development
services (Volume III).6 Pathways to Quality applies these analyses to the levels of
implementation and quality observed in 1999, traces the program changes that led to these
achievements, provides new analyses of service use and program engagement, and identifies the
challenges and successes that the programs experienced during this period. The rest of this
section describes the data sources and analytic methods used to conduct these analyses.
1. Data Sources
Qualitative and quantitative data for this report are from a range of sources: (1) site visits to
the research programs in fall 1997 and fall 1999, (2) observations of program children’s child
care arrangements, (3) parent services follow-up interviews, and (4) Head Start Family
Information System (HSFIS) data collected at enrollment. During the site visits, we:
• Conducted individual and group interviews with program staff, parents, community
members, and local researchers
• Distributed and collected self-administered staff surveys
• Reviewed randomly selected case files to learn about service patterns of individual
families
• Observed service delivery in a center or during a home visit
6
The Leading the Way: Characteristics and Early Experiences of Selected Early Head Start
Programs volumes include: I. Cross-Site Perspectives (ACYF 1999a); II. Program Profiles
(ACYF 1999b); III. Program Implementation (ACYF 2000a); and Executive Summary (ACYF
2000b).
22
Following the site visits, we prepared detailed narrative program profiles and organized
information on program implementation and factors affecting the quality of child development
services into tables and checklists. Program directors reviewed the draft profiles and checklists,
corrected errors and supplied clarifying information, and verified the final profiles and
checklists.
We also drew on data from systematic observations of the child care settings of Early Head
Start children in the research sample. These observations were conducted when children in the
research sample reached 14 and 24 months of age.7 These data include observed child-teacher
ratios, observed group sizes, and Infant-Toddler Environment Rating Scale (ITERS) scores or
Family Day Care Environment Rating Scale (FDCRS) scores as appropriate for the settings in
which research sample children received child care.
Parent services follow-up interviews provided information about families’ use of program
and community services. These interviews were targeted for 6, 15, and 26 months after program
enrollment (and completed an average of 7, 16, and 27 months after enrollment). Most of the
interviews were conducted by telephone with the focus child’s primary caregiver, although some
interviews were conducted in person for those who could not be reached by phone. Finally, we
used data from the HSFIS program application and enrollment forms that were completed by
families when they applied to enroll in the program.
2. Overview of Analytic Methods
This report presents a blend of qualitative and quantitative research. Our analysis of site
visit data yielded rich descriptions of program operations, approaches to service delivery, stories
7
Observations were also conducted when children were 36 months old; they will be reported
in a special policy paper focusing on Early Head Start child care.
23
of change, and dynamics of the wide range of efforts programs developed to meet their families’
needs. We applied systematic and consistent methods to define, describe, and analyze levels of
implementation and indicators of the quality of child development services across all sites. In
addition, we used descriptive statistical methods, including calculating means and frequencies, to
analyze quantitative data from the parent services follow-up interviews, HSFIS application and
enrollment forms, and child care observations. The chapters that follow contain more detailed
explanations of our methods for each of the analyses described in this report.
24
II. PROGRAM DEVELOPMENT AND EVOLVING
PROGRAM APPROACHES
As the Carnegie Corporation’s Starting Points report suggested, providing services to
support the development of infants and toddlers in low-income families is a challenge. The
framework established for Early Head Start (as we reviewed in Chapter I) encompassed several
options for providing such services, and all options required extensive planning at the local level.
Program staff took on the challenges with enthusiasm, implemented a variety of approaches
during their early years, and raised the level of awareness about the importance of providing
services for pregnant women and infants and toddlers and their families. Over time, they fine-
tuned their approaches in response to their experiences and changing contexts for families,
particularly as influenced by changes accompanying welfare reform. Through the lens of the 17
research programs, we see this new national initiative as it is today and how it developed during
its short history. In this chapter, we profile the salient features of the programs’ approaches to
service delivery as of late 1999 and describe what they were like two years earlier. In addition,
we describe the evolution in program approaches, explaining how and why they developed as
they did.
Early Head Start programs strive to achieve their goals by designing program options based
on family and community needs. Programs are required to reassess community needs and
resources regularly (formally, every three years); following each assessment, they reassess the
“goodness of fit” between community needs and program approaches. By design, programs may
offer one or more options to families, including (1) a home-based option, (2) a center-based
option, (3) a combination option in which families receive a prescribed number of home visits
and center-based experiences, and (4) locally designed options. ACYF made this wide range of
25
service delivery options eligible for funding to attract programs that could best serve families
with infants and toddlers in their communities. Because a single program may offer families
multiple options, for purposes of the research, we have characterized programs according to the
options they offer:
• Center-based programs, which provide all services to families through the center-
based option (center-based child care plus other activities) and offer a minimum of
two home visits per year to each family
• Home-based programs, which provide all services to families through the home-
based option (weekly home visits and at least two group socializations per month for
each family)
• Mixed-approach programs, which provide some services to some families through
the center-based option and some through the home-based option, or provide services
to families through the combination or locally designed option (services can be mixed
in the sense either that programs target different types of services to different families
or that individual families can receive a mix of services at the same time or at
different times)
When initially funded, the research programs were about equally divided among these three
approaches, with five center-based, five home-based, and seven mixed-approach programs
(Figure II.1). By fall 1997, as we reported in Leading the Way, the programs’ efforts to find
appropriate ways of meeting their families’ needs had shifted the balance significantly.1 Four
programs were then center-based, seven were home-based, and six were mixed-approach. The
changes, from the point of initial funding to 1997, were a result of such factors as subsequent
funding decisions, changes in families’ needs, and recommendations of technical assistance
providers.
Program evolution did not stop there. By fall 1999, programs offering only a home-based
approach had become the minority (down from seven to two). All four of the center-based
1
For details about the programs’ features and approaches in 1997, see the preceding report,
Leading the Way, Vols. I to III, and executive summary (ACYF 1999a, 1999b, 2000a, and 2000b).
26
FIGURE II.1
BASIC PROGRAM APPROACHES
5
Center-based 4
4
5
Home-based 7
2
7
Mixed-approach 6
11
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Number of programs
When funded Fall 1997 Fall 1999
SOURCE: Information gathered during visits to the Early Head Start research programs in fall 1997
and fall 1999.
NOTE: Early Head Start programs may offer one or more options to families, including
(1) a home-based option, (2) a center-based option, (3) a combination option in
which families receive a prescribed number of home visits and center-based
experiences, and (4) locally designed options. For purposes of the research, we
have characterized programs according to the options they offer to families as
follows:
� Center-based programs, which serve all families through the center-based option
� Home-based programs, which serve all families through the home-based option
� Mixed-approach programs, which serve some families through the center-based
option and some through the home-based option, or serve families through the
combination option
27
programs continued in that mode, but by 1999, 11 programs were offering a variety of “mixed”
approaches to Early Head Start services. Regardless of whether they changed their main
approach to service delivery, nearly all programs added services and grew in complexity (Figure
II.2)
The story of these changes is at the heart of this chapter. We begin the chapter by describing
the contexts in which the research programs developed and how these contexts changed over
time. We then profile each of the 17 research programs as of fall 1999, summarizing their key
features and the changes they made in their approaches to service delivery between fall 1997 and
fall 1999. We end the chapter with a discussion of the themes of change gleaned from our
analysis of the research programs’ development over time.
A. THE CONTEXT FOR PROGRAM DEVELOPMENT
The Early Head Start research program grantees were at various stages of implementing
services for infants and toddlers and incorporating Head Start program features at the time they
were funded. Nine had experience operating Head Start programs for preschoolers, and five of
these had also served infants and toddlers. Another grantee had operated a Parent Child Center
(PCC) as well as a Head Start program and seven had operated Comprehensive Child
Development Programs (CCDPs). Many of the grantee agencies had experience providing
services to infants and toddlers, but five of them were new to Head Start. Three of the program
grantees had not operated Head Start programs, CCDPs, or PCCs, but had operated other
community-based programs. These grantees included a Montessori program that had served
infants, toddlers, and preschool children, as well as a school district and a well-known national
agency that had not.
28
FIGURE II.2
COMPLEXITY OF PROGRAM "APPROACHES"
Families Receive Child
Development Services in:
4
Center-based child care only
4
4
Center-based child care OR weekly home visits
3
Center-based child care OR family child care 1
OR weekly home visits 2
Weekly home visits OR center-based parent-child 1
activities OR center-based child care 0
Weekly home visits OR weekly home/child care 0
visits OR center-based child care 3
0
Weekly home visits OR weekly
home/child care visits 3
Weekly home visits plus child care 0
improvement activities 2
7
Weekly home visits only
0
0 1 2 3 4 5 6 7 8 9
Number of programs
Fall 1997 Fall 1999
SOURCE: Information gathered during visits to the Early Head Start research programs in the fall of 1997 and
fall 1999.
29
The research programs are distributed fairly evenly across all major regions of the country
and across rural and urban areas. Six programs are located in western states (California,
Washington, Colorado, and Utah). Four are in midwestern states (Iowa, Kansas, Michigan, and
Missouri). Four are in northeastern or Middle Atlantic states (New York, Pennsylvania,
Vermont, and Virginia). Three are in southern states (Arkansas, South Carolina, and Tennessee).
About half (eight) of the Early Head Start research programs are in urban areas, and the
other half are in small towns or rural areas. Two programs have sites in both rural/small town
and urban/suburban areas. Both the rural and the urban groups include a mix of home-based,
center-based, and mixed-approach programs.
30
Some of the Early Head Start research programs provided services in more than one site.
Most home-based programs were based in one central place, but two served several communities
and had multiple offices. Most of the center-based and mixed-approach programs operated a
number of centers. Three of the nine programs operated two centers, three operated three
centers, and one operated six centers. The programs that operated three or more centers tended
to be in rural areas and to serve families in more than one county.
The vitality of the economies varies in the areas the Early Head Start research programs
serve. Many of the programs operate in areas where the unemployment rate was 5 percent or
higher in 1995, but seven programs are located where unemployment was lower. In four of the
areas with relatively high unemployment rates, program staff members described job or job
training opportunities as inadequate. By 1998, the unemployment rate in the United States had
fallen to 4.5 percent (from 5.6 percent in 1995), and rates in most of the areas where the
programs operate also fell below 5 percent. Four programs, however, served families in areas
where the unemployment rate was between 5.5 and 10.2 percent.
Although a few of the programs described their communities as “service-rich,” all of them
identified some areas in which services for low-income families were inadequate. All except one
program reported that the supply of affordable high-quality child care in their community was
inadequate to meet the demand, at least for infants, toddlers, and children with special needs.
Thirteen of the programs indicated that their community lacked sufficient affordable housing,
and ten also reported that public transportation was lacking or inadequate. Smaller numbers of
programs noted that health care, mental health care, or dental services were inadequate.
According to staff members in several of the programs, even where services are available, some
families encounter barriers, such as lack of information about the services and how to get them,
eligibility criteria that exclude the working poor, language barriers, unwillingness or inability to
31
seek services because of the time and commitment required, mistrust or fear of the “system,” fear
of stigma, and lack of confidence and experience in seeking services. Lack of transportation also
deters some families from seeking other available services.
B. SALIENT FEATURES OF EARLY HEAD START RESEARCH PROGRAMS IN
1999 AND THEIR KEY DEVELOPMENTS OVER TIME
Over time, some research programs made fundamental changes in their approaches to
serving families, and others made significant changes without altering their basic approach. In
this section, we describe the key features of each program in 1999 and summarize the major
developmental milestones each achieved since receiving Early Head Start funding. We describe
(1) center-based programs that remained center-based, (2) home-based programs that remained
home-based, (3) mixed programs that stayed mixed, and (4) home-based programs that became
mixed.
1. Center-Based Programs—that Remained Center-Based
We begin with the four center-based programs, which were among the five initially funded
to implement center-based child development services and continued with this approach through
1999. Even while continuing to provide center-based services, however, these programs were
not static. These programs (all of which provided full-day, week-day, full-year services, with at
least two home visits per year) were a diverse group. Child Development, Inc. in Arkansas
expanded services into additional counties; Educational Alliance in New York City began as a
half-day program and expanded to a full-day program; Colorado’s Family Star program made a
number of changes to promote quality and continuity of care and to expand services; and
Northwest Tennessee Early Head Start, among other changes, began closer collaboration with
welfare-to-work case managers.
32
Child Development, Inc. Early Head Start (Russellville, Arkansas). Child Development,
Inc., a community-based organization that operates both center-based and home-based child
development programs, including Head Start, operates an Early Head Start program for 108
families in centers in six rural Arkansas counties. The program serves mostly white, working-
poor families, most of which are headed by a single parent. The program provides full-year, full-
time child development services in its centers and offers parent training and case management in
group sessions, during home visits, and in one-on-one sessions at the centers. When they enroll
in the program, parents must agree to spend two hours a week on developmentally appropriate
activities with their child. The program helps parents who need it obtain child care before or
after Early Head Start in the grantee’s centers and obtain state child care vouchers to pay for it.
Families who cannot obtain vouchers receive priority for extended-hours slots in Early Head
Start classrooms. Child development services are based on the premise that children should lead
by expressing their needs and interests and that staff should be there to support them.
Between 1997 and 1999, the program received new grants to expand the number of children
it can serve in Early Head Start from 45 to 108 families, and the program opened new Early
Head Start centers in three additional counties. To accomplish this expansion, the program hired
new staff and changed the supervisory structure. The program also strengthened staff
development by providing financial support to staff who are working toward their associate’s
degrees and by implementing a new salary scale that will increase the pay of teachers with
degrees. In addition to expanding services to more families, the program also increased the
range of physical and mental health services it offers to children and families, and it began
offering services for extended hours to a few children in three of the centers. Four of the six
Early Head Start centers had received NAEYC accreditation by fall 1999, and the two remaining
centers were expected to receive accreditation in spring 2000.
Family Star Early Head Start (Denver, Colorado). Family Star, which operates a
Montessori school for infants and toddlers, operates an Early Head Start program for 75 families
at two centers in northeast and northwest Denver. Many families served by the program are
Latino and speak Spanish. The program provides full-year, full-time child development services
in Family Star’s Montessori school while parents are working or in school and offers monthly
parent education meetings and semiannual home visits. Program services are child-centered, and
staff members speak both Spanish and English with the children.
The program made several changes between 1997 and 1999. It reduced the maximum group
sizes in all classrooms to meet the revised Head Start Program Performance Standards. To
promote continuity of care, the program created a classroom in which the directress stays with
the children as their classroom is transformed from a Nido (classroom for infants up to 14
months old) to an Infant Community (classroom for children older than 14 months). To facilitate
transitions out of Early Head Start, the program received a waiver from the school district to
allow all children in the research sample to attend the city’s Montessori magnet school through
the eighth grade. The staff continues to work on transition plans for other children. The program
now requires eligible families to apply for state child care subsidies to offset a portion of the
costs of operating the school. In addition, it expanded participation in the Child and Adult Care
Food Program to provide breakfast and a snack for children during the school day. The program
hired a mental health coordinator to work with staff and provide services to families and
children.
33
Educational Alliance Early Head Start (New York, New York). The Educational
Alliance, a community-based organization that began as a settlement house and now provides
many services, including Head Start and child care, in New York City, operates an Early Head
Start program for 75 families in three centers. One center is located at the Educational Alliance
headquarters, and two are in schools for pregnant and parenting teenagers. The families served
by the program are ethnically diverse, predominantly single-parent families, about one-third of
whom receive welfare cash assistance. The program emphasizes the development of supportive
relationships and mental health, and in addition to center-based child development services,
provides families with psychotherapy services. Families have access to employment-related and
other support services provided by the Educational Alliance.
The program experienced several major changes between 1997 and 1999. Because of
philosophical differences, it dissolved its partnership with a residential program for pregnant and
parenting substance-abusing women and developed a new partnership with a second school for
pregnant and parenting teenagers. The program received an expansion grant to extend its child
care hours at the Educational Alliance site to full-time (37.5 hours per week), so that it can better
meet families’ child care needs. The original program director left and was replaced in fall 1999.
Northwest Tennessee Early Head Start (Jackson, Tennessee). Northwest Tennessee
Head Start, a program of the Northwest Tennessee Economic Development Council, operates an
Early Head Start program for 75 families in child development centers located in five rural
Tennessee counties and in the town of Jackson. The program serves mostly African American,
single-parent families who are receiving welfare cash assistance. Many parents are teenagers
who live at home with their own mothers. The Early Head Start centers provide full-day, full-
year child care and parent-training activities. Program staff also provide family development
services and referrals designed to help families achieve self-sufficiency, and they focus on
arranging health and developmental screening and treatment services for Early Head Start
children. The program focuses on providing developmentally appropriate, responsive care in a
nurturing environment.
Since it began serving families in fall 1997, the program has increased its focus on health
and development by providing frequent opportunities for comprehensive health and
developmental screening and by advocating intensively for improved Medicaid services for
infants and toddlers. Program staff also began collaborating more closely with welfare-to-work
program case managers. Because there was no early childhood degree program nearby, the
program worked with several local colleges to create an appropriate program so teachers can
begin working toward their associate’s degree. Early Head Start classrooms in four centers
received NAEYC accreditation in 1998. The program’s original director left and was replaced in
fall 1998.
2. Home-Based Programs that Remained Home-Based
Two research programs that were initially funded as home-based programs continued to
provide home-based services to all families through fall 1999. While continuing their efforts to
complete weekly home visits and offer at least two group socializations per month, they
34
extended their efforts to support families’ use of high-quality child care. In Pittsburgh,
Pennsylvania, Family Foundations Early Head Start remained home-based while beginning an
initiative to improve the quality of child care used by its families. In Logan, Utah, Bear River
Early Head Start, in its effort to improve quality and meet the performance standards, made
significant refinements in its approach to enhancing parent-child relationships and began
providing respite care in a small on-site center, but retained its basic home-based approach.
Family Foundations Early Head Start (Pittsburgh, Pennsylvania). The University of
Pittsburgh’s Office of Child Development operates an Early Head Start program for 140 families
in four centers in three diverse communities in the Pittsburgh area. Across the four centers, the
program serves mainly African American and white families headed by single parents, two-
thirds of whom were receiving welfare cash assistance when they enrolled in the program. The
centers provide services to families in home visits: family advocates visit families weekly to
address child development issues, and family development specialists visit families biweekly to
work with them on their goals and link them with community services. Staff members organize
group activities for parents and families at each center. The program also works with child care
providers to develop individual quality enhancement plans and visits providers (mostly family
child care providers) to work with them on implementing the plans. Child development services
focus on working with parents to improve their interactions with their children and in fall 1999
were beginning to focus on working with child care providers to enhance the quality of care they
provide to Early Head Start children.
Between 1997 and 1999, the Family Foundations Early Head Start program, a former
Comprehensive Child Development Program, decided to continue providing home-based
services but enhanced its focus on the child and began a new initiative to improve the quality of
child care arrangements used by Early Head Start families. The program restructured the staff
and created a new staff training curriculum to ensure that staff are knowledgeable about child
development and focus on it in all home visits (including family development visits). The
program also began working with centers and family child care providers to improve quality.
To illustrate this process in greater detail, Carol McAllister, a local research partner with the
Pittsburgh Early Head Start program, describes the program’s evolution to having a greater focus
on child development while remaining home-based (see box on the following page). Through
self-examination, the program modified its emphasis without altering its basic home-based
approach.
Bear River Early Head Start (Logan, Utah). The Bear River Head Start agency operates
an Early Head Start program for 75 families in three rural counties in northern Utah and southern
Idaho. The program serves primarily white, two-parent, working-poor families. The program
provides child and family development services primarily in weekly home visits and weekly
Baby Buddy groups for parents and children. The program also offers respite and drop-in child
care in its on-site center, and program staff are trying to improve the quality of child care by
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Child-Focused Practice in the Pittsburgh Early Head Start Program: A Process of Culture Change
Carol L. McAllister
University of Pittsburgh
The development of a strong child focus, a major goal of the Pittsburgh Early Head Start program, entailed a
reorientation of both thinking and practice from the program’s former status as a Comprehensive Child
Development Program. The process began with a change in the basic approach to families, which came to be
viewed as consisting of concentric circles with the young child in the center, surrounded by parents, older siblings,
and extended family. The child became the focus, with the idea that work with the family should be aimed at
supporting and guiding the child’s development. A creative reinterpretation resulted in an orientation toward
community change that was directed by the ultimate goal of supporting the life and development of young
children.
This change in perspective was followed by a recasting of the program’s basic operating principles to support
a strengthened child-focus. This transformation was affected by (1) local implementation of the revised national
Head Start Performance Standards; and (2) the changing context of family lives, particularly under welfare reform,
the increase in wage work by Early Head Start parents, and the expanded use of out-of-home child care.
In fall 1997, staff questioned the program’s home-visiting model and seriously considered developing a
center-based model or moving to a mixed approach. After much discussion, they opted to keep the home-visiting
model but to adapt it to “follow the child” more closely. This decision was based in large part on a reaffirmation
of core program beliefs, that is, that parents are the most important influences in a child’s life, that the parent-child
relationship is key to the healthy development of the child, and that, therefore, all program interventions should
“go through” or involve the parent and focus on supporting and strengthening the parent-child relationship.
Over time, three strands of activity contributed to the evolution of child-focused practice. The first was
ongoing work, involving all Early Head Start staff, in developing the local practices that would address and
implement the national Head Start Program Performance Standards. Second was the development and
implementation of extensive staff training to increase the knowledge of all program staff in the areas of child
development, developmentally appropriate practice, child and parent health, and parenting education. Third, the
program’s theory of change was revisited several times. Facilitated by the collaboration of program administrators
and researchers, attempts were made to use the theory-of-change framework to reexamine and further elaborate (1)
goals, especially for children; (2) pathways to goals; and (3) practices that addressed various goals or that needed
to be newly created to meet goals. Most significant in terms of the last were the adoption of the PIPE curriculum
as an informal guide to “real-time parenting” education, and a change in approach to out-of-home child care.
Program discussions and decisions about child care were very significant. While there were some
differences of opinion, the strongest voices opposed the promotion of out-of-home child care for infants and
toddlers. However, this critical perspective was counterbalanced by the reality of family lives, especially as time
limits and work requirements of welfare reform increasingly shaped family options and choices. Out of this
discussion emerged a commitment to ensure the best quality and continuity of out-of-home child care when a
family needed it. The result was an innovative child care intervention plan that would (1) partner with formal
child care programs attended by Early Head Start children to provide resources, training, and Early Head Start
staff support for quality improvement; (2) provide encouragement, guidance, and support (especially
transportation) to Early Head Start families to choose quality child care programs; (3) institute a form of home
visiting for relatives and neighbors who were providing the most common form of care for the children; and (4)
use all these to support and strengthen caregiver-child and caregiver-parent relationships.
Each of these program developments entailed changes in the conceptual perspective, knowledge base, and
practice of individual direct-service staff. The specific changes depended on staff role. All home-visiting staff are
now required to obtain a CDA or equivalent educational experience. New staff must now have formal training in
child development. Job descriptions have been rewritten and salary scales adjusted to reflect new responsibilities
and expectations. Perhaps most significant is the expectation that all staff will focus on the ultimate goal of child
health and development, whether their particular role entailed working primarily with parents and children
together or with adult family members on family or community issues or program governance. At the end of the
research period reflected in this report, child-focused thinking and practice had been well integrated into the work
of the staff, and efforts were under way to help families understand and embrace this approach more fully.
36
visiting family child care and relative care settings of program children twice a year. Staff
members work to foster positive parent-child interactions and increase parents’ understanding of
their children’s development. They also work with parents to help them achieve their personal
and family goals and link them with services in the community.
From 1997 to 1999, the program refined its focus on improving parent-child relationships,
infant-parent play interactions, and parental knowledge of child development by adding several
child development staff positions, improving home visitor training based on reviews of
videotapes of home visits, focusing group activities on parent-child interactions, and providing
child development services in its on-site respite center. To encourage active participation in the
program, staff members have begun scheduling more home visits on weekends and in the
evenings, as well as offering special incentives to families who complete Individual Family
Partnership Agreements and volunteer in program activities. The program has also begun
emphasizing involvement of fathers and father figures.
3. Mixed-Approach Programs that Remained Mixed
Six of the seven programs that planned a mixed approach to service delivery at the time of
funding were still operating as mixed-approach programs in 1997 and continued to take such an
approach in 1999, while continuing to evolve. They served some families in center-based
settings and some through the home-based option; in addition, they provided some families with
both center- and home-based services, either at the same time or at different times as families’
needs changed. The Clayton/Mile High Family Futures program in Denver significantly
expanded service options; Project EAGLE, in Kansas City, Kansas, obtained state funding to
boost its ability to provide child care assistance; Sumter (South Carolina) School District 17
Early Head Start expanded its child care options while strengthening the child development
focus of its home visits; Early Education Services Early Head Start, in Brattleboro, Vermont,
increased the home-visit time spent on parent-child activities and took formal steps to ensure the
child care providers met the revised Head Start Program Performance Standards; the United
Cerebral Palsy program in Alexandria, Virginia, improved collaborations with the child care
licensing office; and the Children’s Home Society of Kent, Washington, added child care
classrooms.
37
Clayton/Mile High Family Futures, Inc., Early Head Start (Denver, Colorado).
Clayton/ Mile High Family Futures, Inc., a partnership between a foundation and a child care
resource and referral agency that operates a Head Start program, is operating an Early Head Start
program for 123 families in Denver. The program serves low-income families from diverse
racial and ethnic backgrounds. It provides child and family development services in four ways,
depending on family needs and preferences: (1) in weekly home visits, when children are not in
licensed child care; (2) in weekly visits, two in the home and two at the child care center, when
children are enrolled in licensed child care centers in the community; (3) through full-year, full-
time Early Head Start center-based child development services and monthly visits, alternating
between the home and the center; and (4) through child care in a contracted center and two visits
monthly, one in the home and one at the center. Child development services focus on improving
parent-child relationships and helping parents meet their children’s needs.
From 1997 to 1999, the program changed dramatically. Soon after it received Early Head
Start funding, many staff members who had been with the program when it was a
Comprehensive Child Development Program, including the director, left and were replaced. To
meet the revised Head Start Program Performance Standards, the new staff increased the
intensity of services offered, expanded the service options to meet families’ needs better, and
strengthened the child focus in program services. The program began requiring eligible families
with children enrolled in the Early Head Start center to apply for state child care subsidies to
offset the cost of care, which freed resources and enabled the program to improve other services.
The program also began tracking services more carefully and added a “continuous improvement”
researcher to its staff to help the administrative team monitor progress toward goals and targeted
outcomes. The Early Head Start center received NAEYC accreditation in 1999.
The flow chart on the next page was created by Chris Sciarrino and Rebecca Soden, of the
Clayton Mile High Early Head Start program, to trace the program’s evolution back to its “roots”
in CCDP. It shows how this mixed-approach program remained “mixed” while increasing in
intensity and developing its vision, questions, and expected outcomes.
Project EAGLE Early Head Start (Kansas City, Kansas). The University of Kansas
Medical Center’s Child Development Unit operates an Early Head Start Program, called Project
EAGLE, for 160 families in Kansas City, Kansas. The program serves ethnically diverse
families, half of which were receiving welfare cash assistance when they enrolled. Program staff
members provide child and family development services in two ways: (1) through weekly home
visits or (2) through full-day, full-year child care in a center or family child care home that meets
the revised Head Start Program Performance Standards, plus biweekly home visits (for families
in which the primary caregiver is working or attending school or for families whose child is at
risk or whose situation places program staff at risk). The program has established collaborative
agreements with several child care centers and family child care providers in the area to provide
care for Project EAGLE children, and program staff provide ongoing training and technical
assistance to center staff members and the family child care providers to ensure that Project
EAGLE children receive high-quality child care. The child development services are designed to
increase parents’ responsiveness to their children, engage them in their children’s development,
and empower them to obtain the formal and social supports they need to create a better
environment for their child.
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Evolution Of Clayton/Mile High Early Head Start
Chris Sciarrino and Rebecca Soden
Clayton/Mile High Early Head Start
Denver, Colorado
CCDP EHS BEGINS EHS CHANGES SHAPE
“Roots” “Organic Period” “Blossoming” “Flourishing”
• Serves 0 to 5 years • Serves 0 to 3 years
• Original grant: How do we deliver
family-friendly services and support • How do we intervene early in order to show outcomes for children and families?
children?
QUESTION Goals:
Shift in goals to: • Child Development/Health
• School Readiness • Early Childhood Education
• Systems Change • Family and Community Partnerships
• Reduced Welfare Dependency • Staff Development
“Through the eyes of the family” “Through the eyes of the child”
39
Vision Family Services—Child Development and Integral Piece • Child Development—Family Services an
Integral Piece
Belief Self-sufficiency Child Outcomes Intensity of Children’s Services
Child Outcomes
Expectation: Home Visits 4 Times/Month
Intensity Program Design did not meet this standard Program Design meets the
standard
Rationale = Cost/Unit of Service Rationale = Dosage Child Outcomes
• Original Grant: “One Stop Shopping”
Resources Campus Services
Shift to: Community Resource Referral
Campus Services Consultative
• Notion did not exist • Continuous Improvement Model
• Tracked through MIS data Outcomes Matrix developed Outcomes Matrix refined
Outcomes • Ethnographer reports defined by what Program activities not aligned Program activities aligned with
DC wanted (not tied to outcomes) with standards standards
Reports generated in response to
outcomes
From 1997 to 1999, the program received state funds to serve more families and to add staff.
The program also obtained state funding to pay for child care, so it no longer has to rely
primarily on state child care subsidies for individual families and has more flexibility to provide
child care assistance during changes in employment (when families may lose their eligibility for
state subsidies). The program also developed and implemented a best-practices tool designed to
help home visitors see themselves as agents of change, improve service quality, and make
services more consistent across caseloads. The program has formed new partnerships with child
care providers and is investing more resources into staff training to promote higher-quality child
care. The diagram on the next page illustrates the service model for Project EAGLE. It depicts
the mixed program’s model of services in fall 1999, with the multiple service options that have
evolved to meet the diverse needs of families.
Sumter School District 17 Early Head Start (Sumter, South Carolina). School District
17 in Sumter, South Carolina, operates an Early Head Start program for 75 families. It provides
full-year, full-time center- or home-based child development services to pregnant and parenting
primary and secondary school-age students and young high school graduates who are employed.
Most of the parents in the program are African American teenagers. Parent educators conduct
weekly home visits with families whose children are not enrolled in the centers and less-frequent
home visits with other families to work with them on parenting and child development, help
them identify their needs and goals, and link them to services in the community. Child
development services focus on (1) teaching parents to take responsibility for themselves and
their children, (2) teaching them how to obtain the resources they need to be better parents, and
(3) providing high-quality child care that is child-centered, child-directed, and adult-supported.
From 1997 to 1999, the Sumter Early Head Start program reorganized its staff to ensure a
stronger focus on child development in home-based services. The program also began
contracting with a community child care center to provide Early Head Start care to up to eight
children, and through that relationship is working to improve the quality of child care in the
community. The program’s relationship with the Part C agency has improved as staff members
have worked with Part C service providers in center classrooms and learned about caring for
children with disabilities. The program has increased its visibility and acceptance in the
community.
Early Education Services Early Head Start (Brattleboro, Vermont). The Brattleboro,
Vermont, school district’s Early Education Services office operates an Early Head Start program
for 107 families in rural Windham County. The program serves primarily white families, half of
which include both parents. The program provides child and family development services,
primarily in home visits. It also provides full-year, full-time center-based child development
services for a small number of families and brokers child care for 20 children in family child care
homes and center-based settings in the community. After the first year, the program often
reduces the number of home visits to two per month and adds two visits per month to the center
where the child is receiving care. The program also organizes play groups and monthly parent-
child group activities. Teams of staff members work with families to build on their strengths and
achieve their personal and family goals, and they link families with needed services in the
community. Child development services are designed to promote strong parent-child
relationships and positive interactions.
40
Project EAGLE Early Head Start/Head Start Program Options
Martha Staker
Project EAGLE Early Head Start
Kansas City, Kansas
Program Eligibility – Determines if applicant meets eligibility criteria
Enrollment – Families prioritized based on need/community assessment
12-Week Orientation Period – The partnership and assessment process results in the family selecting the program option
that best meets their family needs/situation
Option #1 Home Based Services Option #2 Combination Services Option #3 Advanced Combination
Services
Who is eligible: Who is eligible:
– All families enrolled in Project EAGLE. – Families in which primary caregiver is Who is eligible:
– Primary caregiver has a willingness to working or in school. – Primary caregiver is working,
meet weekly and is capable of learning, – Primary caregiver is actively participating demonstrating skills in parenting, and
modeling, and nurturing infant/child. in home visits and engaged in their child’s assuming greater responsibility for self-
– Infant/toddler appears to be thriving in a development. sufficiency.
safe and nurturing environment. – Infant/toddler is in developmentally – All children are in developmentally
Frequency of services: appropriate child care center or home that appropriate child care centers or homes
– Family support advocate makes weekly meets the Head Start Performance that meet the Head Start Performance
home visits and engages all family Standards. Standards.
members in program. Frequency of services: Frequency of services:
– Family support advocate makes biweekly – Family support advocate makes monthly
home visits and engages all family or bi-monthly home visits, providing
members in program. continuity of services through a trusting
– Family support advocate meets semi- relationship. The family support advocate
annually with child care provider, parents, and/or child care specialist visit the child
and Part C at the child care site. care site biweekly to observe the child,
– One visit per month may occur at child track attendance, and support the provider
care site. of early care and education.
Cost: – Family support advocate meets
– State subsidy or program dollars are used semiannually with child care provider,
to pay for child care. parents, and Part C at the child care site.
Costs:
– State subsidy or program dollars are used
to pay for child care.
Assessment and re-evaluation of family’s progress
Transition and graduation
Center-Based Services
(When infants/toddlers or staff are at risk)
Who is eligible:
– Infants or toddlers are at risk due to exposure to substance abuse, criminal activity, domestic violence, abuse/neglect, or single
parent is overwhelmed and unable to care for children.
– Safety in the home is an issue for the family support advocate.
Frequency of services:
– Infants/toddlers are in full-time developmentally appropriate child care centers or homes that meet the Head Start Performance
Standards.
– No home visits are occurring but program staff attempt to contact families on a monthly basis to re-engage them.
– The child care specialist will check on child’s attendance and well-being on a biweekly basis.
Cost:
– Programmatic dollars are used for child care unless at-risk dollars are allowable through the state.
41
From 1997 to 1999, the program, a former Comprehensive Child Development Program,
increased its child focus by spending more time during home visits on parent-child activities and
sponsoring a community college course in child development, in which staff and participants
receive priority in enrollment. The program also took on direct responsibility for developing
written agreements with licensed child care providers to care for Early Head Start children. In
these agreements, the providers agree to adhere to the relevant portions of the revised Head Start
Program Performance Standards, and the program agrees to supplement subsidy rates when
needed and provides materials and equipment as necessary. During the past three years, Early
Education Services also became a Head Start grantee and worked toward providing continuous,
seamless services to children from birth through age 5. The director took a leave of absence,
returned for a year, and then left permanently.
United Cerebral Palsy Early Head Start (Alexandria, Virginia). United Cerebral Palsy
of Washington, DC, and Northern Virginia operates an Early Head Start program with a special
emphasis on children with disabilities for 75 families in Fairfax County, Virginia. The program
serves an extremely diverse group of working-poor families, including military families. Many
are immigrants who do not speak English or do not speak it well. The Early Head Start program
provides child development services to some families full-time in a child care center, some
families full-time in family child care, and some families in weekly home visits. Families with
children enrolled in the child care center or in family child care receive family development
services in monthly home visits. Families are also invited to group socialization activities three
times a month. The program provides inclusive services to children with disabilities and works
to foster inclusive services for all children in the community.
From 1997 to 1999, the program developed collaborations with new community partners
and improved its collaborations with the county child care licensing office and Part C and Part B
service providers. The program also enhanced child development services by maintaining
portfolios for each child in the center, increasing the frequency of group socializations and
providing transportation to them, and adding an additional child development assessment tool.
The original program director left and was replaced in late summer 1999.
The Children’s Home Society of Washington—Families First Early Head (Kent,
Washington). The Children’s Home Society of Washington operates the Families First Early
Head Start program for 120 families in South King County. The Early Head Start program
builds on the agency’s experience as a child welfare agency and as a former Comprehensive
Child Development Program. The program serves diverse families, half of which were receiving
welfare cash assistance when they enrolled. It provides child and family development services in
three ways: (1) through weekly home visits and biweekly group socializations; (2) in Early Head
Start classrooms in full-year, full-time child care centers operated by the Children’s Home
Society, with monthly home visits and bimonthly group socializations; and (3) through a
combination of services, either (a) in two home visits and two child care visits per month, or (b)
in child-parent/parenting classes for 12 hours per week plus monthly home visits. All families
also receive monthly home visits from a public health nurse. Child development services focus
on building supportive relationships, especially between parents and children.
From 1997 to 1999, the Families First Early Head Start program expanded case management
services and increased its emphasis on mental health. It also added child care classrooms and
42
added new group socialization activities. The program has experienced considerable staff
turnover, including two directors, although the original director still works for the Children’s
Home Society and provides some oversight. To increase staff retention and improve services,
the program increased salaries, added more case management staff, and formed a support group
for frontline staff.
4. Home-Based Programs that Became Mixed-Approach Programs
Five of the programs that were funded as home-based programs continued in this approach
in 1997, but expanded the service options they offered to families so that by 1999 they were
mixed-approach programs: (1) the Venice Family Clinic Children First Early Head Start, in
Venice, California, increased home visitors’ focus on parent-child relationships and child
development and began paying for and supporting the quality of child care used by some
families; (2) Mid-Iowa Community Action, in Marshalltown, Iowa, took on greater responsibility
for helping families find child care and began conducting visits with child care providers; (3)
Community Action Agency Early Head Start, in Jackson, Michigan, added a child care center to
serve some of its families; (4) KCMC Early Head Start, in Kansas City, Missouri, began working
with community partners to improve community child care and visiting children in their child
care settings; and (5) the Washington State Migrant Council’s Early Head Start program, in
Yakima Valley, Washington, began offering center-based services at one of its sites.
Venice Family Clinic Children First Early Head Start (Venice, California). The Venice
Family Clinic, a private, community health clinic that has provided health care to low-income
families for many years, operates the Children First Early Head Start program for 100 families in
the Venice area. The program, which serves primarily Hispanic families, provides child and
family development services to most families in weekly home visits and biweekly group
socialization activities. The program refers families who need child care to a state-funded
resource and referral agency that screens providers, makes referrals, and monitors quality. In
addition, the program now funds child care for 15 children whose families cannot afford it.
Providers who care for these children must sign a contract that requires them to meet many Head
Start Program Performance Standards. Families receiving program-funded child care receive
child and family development services in a combination of home and child care visits and in
biweekly group socialization activities. The child development services focus on strengthening
parents’ and caregivers’ relationships with children through instruction and modeling.
43
From 1997 to 1999, the program strengthened its focus on child development by hiring new
staff with child development and early intervention expertise and by strengthening the training
and supervision of home visitors. These changes have helped home visitors focus consistently
on parent-child relationships and child development. The program also increased its focus on
child care quality by funding some child care and requiring funded providers to make
improvements, get ongoing training, and meet standards. All these changes have resulted in part
from suggestions by Head Start Bureau monitors and from a self-assessment in which small
workgroups of staff and parents addressed various program issues. In fall 1999, the program
director, who had been with the program since its days as a Comprehensive Child Development
Program, left and was replaced.
Mid-Iowa Community Action, Inc. Early Head Start (Marshalltown, Iowa). Mid-Iowa
Community Action, Inc., a community-based organization that has provided services (including
a Head Start program) to low-income families for 24 years, operates an Early Head Start
program for 75 families in five rural counties in central Iowa. The families are primarily white,
and many are two-parent households. The program provides child development services in
weekly home visits (or home and child care visits) and family development services in separate
biweekly home visits. The program also holds monthly parent meetings in each county. The
child development services focus on strengthening parents’ skills and abilities as their children’s
first teachers.
From 1997 to 1999, the program, which is a former Comprehensive Child Development
Program, made a number of changes to meet families’ increasing needs for child care in the
wake of welfare reform. Home visitors became responsible for helping parents find child care,
and child development home visitors now conduct two visits per month in the child care setting
and two per month at home for families using child care. The program also began offering
training and materials to community child care providers to help improve child care quality.
Staff members are planning to add center-based child care services for eight children.
Responsibility for program management became more decentralized, and county directors now
oversee all county office activities, including collaboration and fundraising.
Community Action Agency Early Head Start (Jackson, Michigan). Community Action
Agency, a community-based organization with more than 30 years of experience (some as a
Head Start grantee) serving low-income families, operates an Early Head Start program for 95
families in Jackson and Hillsdale counties. The Early Head Start program builds on the agency’s
infant mental health program. The families in the program are mostly white, single-parent
families. The program provides child and family development services primarily in weekly
home visits by registered social workers and monthly play groups for parents and children.
Home visitors work extensively with parents on their problems in order to enable them to be
better parents. The program also provides full-year, full-day child care for 8 infants and toddlers
in a center in the city of Jackson, and planned to increase the size of the center to 16 children in
2000.
The program changed significantly between 1997 and 1999. Following a monitoring visit
by the Head Start Bureau, the program intensified its focus on child development by increasing
the amount of home visit time devoted to the child and by bringing learning materials to visits
more often. To improve the quality of child care, the program provides some center-based care
44
directly and convenes monthly meetings of child care providers to discuss developmentally
appropriate practices. Along with Head Start, the Early Head Start program is a key part of the
agency’s 0 to 5 focus and its efforts to promote family self-sufficiency.
KCMC Early Head Start (Kansas City, Missouri). KCMC Child Development
Corporation, a community-based organization that provides child care and Head Start services to
low-income families, operates an Early Head Start program for 75 families in the poorest
neighborhoods of Kansas City. The Early Head Start program serves primarily African
American, single, teenage parents, two-fifths of whom were receiving welfare cash assistance
when they enrolled. The program provides child and family development services in three ways:
(1) through weekly home visits; (2) through monthly home visits and monthly child care visits,
for children enrolled in licensed child care centers; and (3) through one to two home visits and
one to two child care visits for families whose children are in a family child care setting in which
the provider has agreed to work with the program on quality improvement. The program also
offers several group socialization opportunities for parents and children each month. Child
development services focus on establishing and supporting parent-child relationships and
working with parents to support their children’s development.
From 1997 to 1999, KCMC Early Head Start made several changes to strengthen its focus
on child development. The program entered a partnership with a child care center to provide
center-based services for some children. Following a Head Start Bureau monitoring visit, and
after a new program director assumed leadership in early 1997, program staff took responsibility
for child development home visits (previously, a program partner was responsible) and received
significant training in child development to enable them to do so. Home visitors also began to
develop individual child development plans with families. The program hired a child
development coordinator to serve as a resource, consultant, and trainer in the areas of prenatal
health and education, child health and development, disabilities/special needs, and transitions. In
summer 1999, KCMC received a state grant to work with community partners on improving the
quality of child care in the community.
Washington State Migrant Council Early Head Start (Yakima Valley, Washington).
The Washington State Migrant Council, the largest Hispanic-operated and Hispanic-serving
organization in the Northwest, operates a Migrant Head Start program as well as Early Head
Start for 75 intrastate and former migrant families2 in six small towns in Yakima County. The
program serves many first-generation Mexican Americans who migrated to Washington to work
on farms. Many speak only Spanish. The program provides child and family development
services primarily in weekly home visits and group activities for parents and children. Child
development services focus on establishing supportive relationships and enhancing the social and
verbal contexts for early childhood development. The program celebrates families’ Mexican
American heritage and culture and emphasizes sensitivity to families’ concerns with
acculturation.
2
These families are those who stay within the state or who have “settled out” and no longer
migrate across state lines.
45
From 1997 to 1999, the program increased the frequency of home visits to meet the revised
Head Start Program Performance Standards that took effect in January 1998, and opened a child
care center to provide center-based services in one of its sites, extending services to Native
American families as well as to the Hispanic population. It also increased its emphasis on
mental health by hiring a specialist both to work directly with families and to improve staff’s
understanding of mental health issues. The program has increased outreach to fathers and
worked to make program activities more appealing to them. The program experienced two
changes in directors during the three years of program enrollment.
C. THEMES OF CHANGE
A number of themes characterize the changes we observed in programs approaches to
service delivery. In this section, we describe themes related to the reasons changes in program
approaches were made. These include changes in families’ needs, the need to improve the fit
between program services and family needs, increasing clarity of expectations, and program
responses to monitoring and technical assistance. We also describe several themes related to the
kind of changes programs made. To navigate changes in their approaches to service delivery,
programs often needed to make changes in their approach to improving child care quality for
program children, expectations for program staff, and relationships with child care providers.
Changing Family Needs. Between fall 1997 and fall 1999, many families experienced a
greater need for child care as their children got older. Parents also responded to TANF work
requirements and time limits by participating in education or job training programs and by
seeking and obtaining employment. Increasing needs for child care led programs to develop
ways of ensuring good quality in the child care arrangements families used. At the same time, in
home-based programs parents became less available to meet with home visitors and were less
receptive to home visits during evenings and weekends when they were tired or needed to do
other things, although home visitors became more flexible in scheduling home visits. In
response to these changes in family needs, some programs began offering child care directly, and
some programs added the option of visiting children both at home and in their child care setting.
46
Increasing Fit of Program Services to Family Needs. Even in sites where families’ needs
did not change, early experiences demonstrated that some programs’ approaches to serving
children and families did not always match well with families’ needs. Programs learned from
these early experiences and made changes to their approaches to better meet families’ needs.
Increasing Clarity of Expectations and Goals. During the early years of Early Head Start,
the Head Start Bureau clarified many expectations about how this new program should be
instituted. The Head Start Bureau approved the new performance standards, provided written
guidance, training, and monitoring. In addition, the Head Start Bureau clarified its expectation
that programs take responsibility for helping all families who need child care find good-quality
child care arrangements that comply with the performance standards. As this requirement
became clearer, some of the research programs adjusted their approaches to focus more on child
care quality. As Head Start Bureau expectations were clarified, programs also engaged in
adjusting and refining their goals and approaches.
Responding to Monitoring and Technical Assistance. Programs often made changes in
their approaches in response to feedback and encouragement from Head Start Bureau monitors
and training and technical assistance consultants. Sometimes the monitors or consultants
suggested specific changes, and sometimes they recommended self-assessment or planning
processes that led programs to make changes. Many home-based programs received a clear
message from federal project officers that the program needed to become more child-focused. In
several cases programs that were once family-support oriented changed to incorporate an explicit
child development focus.
Increasing Focus on Improving Child Care Quality for Individual Children. Some
programs had previously worked with community collaborative groups and through partnerships
with child care resource and referral or other agencies to improve the quality of child care in
47
their communities. The changes programs made in their approaches reflected a shift in focus
from working on overall child care quality in the community to improving the quality of specific
arrangements in which Early Head Start children received care.
Changing Expectations for Program Staff. Changing approaches required substantial
effort on the part of staff. Often the change entailed designing new services (such as child
development and quality enhancement services to be provided in child care provider visits, or
center-based child development services to be offered in a new center). New services created
new expectations for program staff families with the former services. Some staff changed from
being home visitors to working in centers. Others experienced changes when positions were
reconfigured, when supervisory responsibilities changes, or as definitions of their jobs otherwise
changed.
Building Relationships and Developing New Partnerships with Community Child Care
Providers. Many programs built new relationships with child care providers and some
established formal partnerships. These new relationships and partnerships were sometimes the
reason for change and sometimes the result of it. Most of the Early Head Start programs grew in
outreach to the child care community during the period of change we assessed. Programs
developed relationships for training, formalized partnerships for meeting the performance
standards, visited Early Head Start children in their child care settings, shared information about
children’s developmental assessments, and worked generally in partnership with the providers on
behalf of the child.
Obtaining Additional Resources. When programs added a center-based option, they
usually had to obtain additional resources for creating new child development centers and hiring
new staff. When programs added child care visits to home visits or began developing
partnerships with child care providers, they needed resources to pay for hiring new staff, training
48
staff to perform new functions, and providing resources and support to child care providers. The
research programs received additional funds from a variety of sources, including expansion
grants and quality improvement grants from ACYF, state Early Head Start grants, state child
care subsidy funds, and other grants.
D. SUMMARY
The discussion in this chapter illustrates that Early Head Start programs experienced many
changes during their first three years of serving families. A number of programs changed their
main approach to service delivery, while others retained their basic approach but refined it.
These changes were not confined to programs in a particular area of the country, or to a
particular type of program auspice, but, rather, seemed to be a phenomenon common to all or
nearly all programs. In subsequent chapters, we will describe in more detail the implementation
issues program faced as they developed.
49
III. PROGRAMS’ THEORIES OF CHANGE AND THEIR
EVOLUTION OVER TIME
A. INTRODUCTION
“Theories of change” are increasingly important in program evaluations (Birckmayer and
Weiss 2000; Connell and Kubisch 1998; and Weiss 1995). They provide a way for programs to
identify the specific outcomes they expect to achieve and to describe the programmatic strategies
and activities that they have designed. Theories of change (sometimes called “logic models”)
also make it possible for program evaluators, working with program staff, to identify the
outcomes that programs expect their services to influence in the various areas they focus on,
select ways of measuring these expected outcomes, and plan analyses that will focus on the
outcomes that the programs believe to be important. In the Early Head Start evaluation, theories
of change contribute both to our descriptions of the program intentions and processes and
planning the analyses of program impacts.
From its very beginning, the Early Head Start evaluation has emphasized the importance of
understanding the expected outcomes of the 17 research programs. In 1996, shortly after most of
the programs were funded, the national evaluation team began to engage both local researchers
and program directors from the research sites in discussions of theories of change. In many sites,
research-program discussions continued. We first reported on the programs’ expected outcomes
in Volume I of Leading the Way: Characteristics and Early Experiences of Selected Early Head
Start Programs (ACYF 1999a). That report was based on information from 1997 site visits and
1998 discussions with the 17 program directors. It presented three perspectives on the programs’
expected outcomes: (1) all the “important” expected outcomes that programs articulated, as
obtained from interviews conducted during fall 1997 sites visits; (2) the program directors’
51
reports of the three “highest-priority” outcomes for their programs, obtained in a spring 1998
meeting; and (3) directors’ descriptions of a “success story” that exemplified outcomes they had
achieved with their children and families.
The theory-of-change discussions presented in Leading the Way described expected
outcomes in five areas: (1) parent-child relationships, (2) child development, (3) family
development, (4) staff development, and (5) community building. Since spring 1998, theory-of
change discussions continued among the research-program partners across the sites, and in the
summer/fall 1999 site visits, the national team explored any changes in the programs’ expected
outcomes in these five areas. We acknowledge that the approach taken to describing and
understanding programs’ expected outcomes contained variability. Participating staff
represented different roles across sites and spent varying amounts of time on this activity, both
during and between site visits. Site visitors were balancing competing demands and devoted
differential attention to obtaining details on their programs’ expected outcomes. Finally, the
process conducted in 1999 differed somewhat from the way it was conducted in 1997, so the two
sets of information are not entirely comparable. In spite of these caveats, however, the Early
Head Start evaluation was successful in obtaining extensive information on the expected
outcomes of all 17 research programs at different points in time. The information is useful for
describing the focus and change in expected outcomes over time, as we do in this chapter.
Table III.1 presents the expected outcomes for each program as described to us in 1997 and
1998 and in 1999.1 All important program outcomes are listed in the table, with the ones
identified by the programs as priority outcomes at each time point shown in italics. The rest of
1
This table adds the 1999 information to the expected outcomes reported in Table II.6 of
Leading the Way, Volume I.
52
TABLE III.1
OVERVIEW OF KEY OUTCOMES IDENTIFIED BY PROGRAMS IN 1997 AND 1999
Programs Parent-Child Relationships Child Development Family Development Staff Developmentb Community Buildingb
A Parental knowledge of child Cognitive development Physical health, mental health Improved staff competencies Quality of community child
development Cognitive, language, social- and healthy family Staff competencies and care, quality of other
1997
Attachment, knowledge of child emotional, physical, approaches functioning, self-sufficiency, community involvement community services,
development, and understanding the toward learning, and school literacy and education, and coordination of services and
parent-child relationship readiness home environment collaboration, and
involvement of parents in the
community
1999 Enhanced parental competencies Enhanced cognitive and Better mental health, physical Improved staff competencies Increased quality of
Stronger attachment, enhanced language development health, healthier family More community involvement community child care,
knowledge of child development, Enhanced social-emotional functioning, greater self- increased quality of other
more understanding of the parent- development, greater school sufficiency, increased literacy community services, greater
child relationship readiness, better physical and education, and enhanced coordination of services and
development, better approaches home environment collaboration, and more
toward learning involvement of parents in the
community
B Parent-child relationships Cognitive, social-emotional, Mental health Staff self-esteem Quality of community child
Attachment and knowledge of child physical, and school readiness Physical health, mental health Staff competencies care and involvement of
1997
development, and healthy family parents in the community
functioning, self-sufficiency,
and home environment
53
1999 Parent-child relationships Age-appropriate levels of Mental health Staff self-esteem Increased availability and
Secure attachment, parenting efficacy cognitive, social-emotional, Physical health, self- Greater competence and better quality of community
physical, and language sufficiency, physical and teamwork child care, greater
development emotional quality of the home sophistication of parents as
environment (stable, consumers of health, social,
nurturing) and educational services
C Parent-child relationships Cognitive, social-emotional, Self-efficacy Improved staff competencies Involvement of parents in the
Attachment and knowledge of child physical, approaches toward mental health and healthy Staff competencies and career community
1997
development learning, and readiness for Head family functioning, self- development
Start sufficiency, and literacy and
education
1999 Enhanced parent-child relationships Cognitive development Parent self-efficacy Improved staff competencies Increased involvement of
Increased knowledge of child Social-emotional development Improved mental health and Career development parents in the community
development Healthy physical development healthy family functioning,
and readiness for Head Start improved literacy and
education, and healthier
lifestyles
D Parent-child relationships Cognitive, social-emotional, Economic self- Improved staff competencies Involvement of parents in the
Knowledge of child development approaches toward learning, and sufficiency/employment Staff competencies and community
1997
school readiness Self-sufficiency and home teamwork and morale
environment
TABLE III.1 (continued)
Programs Parent-Child Relationships Child Development Family Development Staff Developmentb Community Buildingb
1999 Knowledge of child development and Cognitive development Parent self-sufficiency (skills Improved staff competencies Increased collaboration and
of how to stimulate young children Social-emotional development necessary for employment, (successfully transitioning partnerships with community
(social skills, willingness to access services on own) from Head Start to EHS, services providers
share, self-esteem) increased training and
Physical development education), increased
Approaches toward learning supportive supervision
(independence and self-help
skills)
E Parental knowledge of child Cognitive development Family goal setting Staff development not Community cornerstone not
development Social-emotional and approaches Mental health and healthy discussed during site visit discussed during site visit
1997
Attachment, knowledge of child toward learning family functioning, self-
development, and understanding the sufficiency, and home
parent-child relationship environment
1999 Enhanced parental knowledge of Cognitive development Enhanced family goal setting Increased staff Greater awareness of
child development and children’s Social-emotional; approaches Healthier family functioning, professionalism (awareness community child care needs
needs toward learning; emergent greater self-sufficiency; and assessment of family and importance of early
Stronger attachment; better literacy skills enhanced home environment needs, ability to make education issues; increased
understanding of the parent-child appropriate referrals, staff supply and quality of child
relationship have goal of improving in this care; more coordination of
area) services and collaboration
Greater staff skills and with community partners;
knowledge about child greater community
development and child care knowledge about low-
income families
F Understanding the parent-child Language development Literacy/education Staff competencies and Improved quality of
relationship Cognitive, social-emotional, and Mental health and healthy teamwork and morale community child care
1997
physical family functioning, self- Involvement of parents in the
sufficiency, literacy and community
education, and home
environment
Improved understanding of the Improved language, cognitive, Parental mental health Greater competencies, Improved quality of
1999
parent-child relationship social-emotional, and physical Family education and literacy teamwork, and morale community child care,
development Healthy family functioning greater involvement of
(stable home environment) parents in the community
Increased self-sufficiency,
better quality home
environment
G Parent-child relationships Parenting Cognitive, language, social- Mental health and healthy Improved staff competencies Quality of community child
stress emotional, and approaches family functioning, self- Staff competencies, teamwork care, and coordination of
1997
Attachment, knowledge of child toward learning sufficiency, and father and morale, career services and collaboration
development, and understanding the involvement development, and community
parent-child relationship involvement
TABLE III.1 (continued)
Programs Parent-Child Relationships Child Development Family Development Staff Developmentb Community Buildingb
1999 Stronger and secure parent-child Demonstrate gains in language Decreased family stress Better prepared, trained staff Children and parents will
attachment and social development, be ready Parents advocate for their have access to
Parents understand and promote to learn children, and act on developmentally appropriate
child development (identify anticipatory guidance and child care, family members
developmental milestones, monitor education related to their own will volunteer in the
and support development) and child’s health, fewer life community
crises and respond to crises
and stress with constructive
decision making, live in
affordable safe homes free of
substance abuse an d illegal
activities, have extended social
support system, purchase and
prepare meals meeting
family’s nutritional needs,
employment that meets basic
economic needs and provides
opportunities for advancement,
if no GED will complete adult
55
basic education or advance 2
grade levels, have employable
skills and means of
transportation, be financially
stable and able to financially
plan for future
H Parent-child relationships Language, social-emotional, Self-sufficiency, home Improved staff competencies Quality of community child
Parental knowledge of child physical, approaches toward environment, and father Staff competencies, teamwork care, quality of other
1997
development learning, and school readiness involvement and morale, and career community services,
Attachment, knowledge of child development coordination of services and
development, and parenting collaboration, and
involvement of parents in the
community
1999 Enhanced parent-child relationships Enhanced functioning in domains Greater family self- Improved staff competencies, Enhanced quality of
(attachment parenting, increased of language, social-emotional sufficiency, improved home teamwork, and morale; career community child care,
nurturing, increased responsiveness development (secure attachment, environment, greater male development quality of other community
to child) positive peer play interactions at involvement and social services, coordination of
Parental knowledge of child age 3), physical development and networking services and collaboration,
development (what is health, approaches toward and parent involvement in
developmentally appropriate) learning, and school readiness the community
Infant-parent play interaction
TABLE III.1 (continued)
Programs Parent-Child Relationships Child Development Family Development Staff Developmentb Community Buildingb
I Attachment, knowledge of child Cognitive development Physical health, mental health Staff development not Quality of community child
development, understanding the Language development and healthy family discussed during site visit care, quality of other
1997 parent-child relationship, and Social development functioning, self-sufficiency, community services,
parenting Social-emotional and physical and home environment coordination of services and
collaboration, and
involvement of parents in the
community
1999 Increased security of parent-child Achievement of appropriate Increased family self- Advocate for and with families Link agencies and service
attachment developmental milestones sufficiency providers
Increased parental availability to the Ability to emotionally connect Increased family access of
child with parent and others (this appropriate community
Parent is available for the child encompasses confidence and resources
(emotionally and physically); self-esteem, emerging sense of Decreased number of unsafe
increase in parents ability to read self, and having a secure base); home environments
cues (communication needs to be for delayed/disabled children, Parent has increased self-
reciprocal and parent needs to learn promote maximum regulation and ability to
to speak for the child); child has a development and growth; delay gratification; increased
secure base to return to (explore achieve developmental income, education, and
and grow); empathic listening, satisfaction with life; become
56
milestones (language/ motor
holding interactions; parent skills/ cognitive); increased financially independent;
expresses pleasure of child/ self-regulation and ability to parents establish and
acceptance of child withstand delayed gratification maintain healthy
relationships; use a healthy
support system, give a voice,
reduce isolation; understand
consequences of choices and
actions; increased safety
J Parent-child relationships Cognitive, social-emotional, Literacy/education Staff competencies and career Quality of community child
Knowledge of child development, physical, and approaches toward Physical health, mental health development care
1997
understanding the parent-child learning and healthy family Quality of community child
relationship, and parenting functioning, self-sufficiency, care, quality of other
literacy and education, and community services,
home environment coordination of services and
collaboration, and
involvement of parents in the
community
TABLE III.1 (continued)
Programs Parent-Child Relationships Child Development Family Development Staff Developmentb Community Buildingb
1999 Stronger parent-child relationships More social, initiate play; Greater parental Increased knowledge of child Quality of community child
Parents will understand rationale of verbalize feelings better; ready literacy/education development, increased care
CD activities and continue them after for school academically; ready Parents attain better sense of knowledge of community Parents understand
specialist leaves; parent feels better for school in terms of family’s needs; greater resources, attitude consistent importance of continuity and
about self and more available to temperament; increased social confidence in parenting; better with philosophy of family quality and can evaluate
child; understand where child is competency; improved health environment for children; strengths rather than deficits; quality of child care and
developmentally and recognize (including immunization rates) more stable homes; parents take advantage of make informed choices;
changes, understand link between empowered to know and ask opportunities in the develop relationship with
child’s language and communication for what they need; think of community their child care provider;
and reduced violence later; increased solutions to own dilemmas, systems affecting children
understanding of why CD is higher self-esteem; greater will be more sensitive to
important; actively teach children and confidence in achieving goals; child and family needs; more
read to them more; more activities greater family self-sufficiency; streamlined services; parents
conducive to CD; reduced abuse and better family health (including are listened to and heard in
neglect; increased parent-child prenatal care, knowledge of relation to community
interactions own bodies, sexuality and building; parents positive
STDs); more assertive in role model for peers in the
advocating for own children; community
more-positive outlook on life;
more positive approach to own
and child’s well-being; have
plan of action regarding
achieving goals; increased
social competency; sufficient
literacy to seek solutions and
help from agencies; greater
knowledge of community
resources/ learning
opportunities; fathers involved
K Parenting confidence and Social-emotional development Self-sufficiency and home Staff competencies Quality of community child
competence Cognitive, language, social- environment care and involvement of
1997
Parent-child relationships emotional, physical, and parents in the community
Knowledge of child development and approaches toward learning
parenting
TABLE III.1 (continued)
Programs Parent-Child Relationships Child Development Family Development Staff Developmentb Community Buildingb
1999 Enhanced parent-child relationships Better social-emotional Enhanced ability of parents to Stronger staff competencies Higher quality of community
(age-appropriate play with child, development meet the family’s social and (obtain CDAs); enhanced staff child care; more involvement
positive intra-family relationships) Cognitive development (fewer economic needs (self supervision and support of parents in community
Greater parenting confidence and developmental delays, holistic sufficiency) (able to obtain (advocating for selves,
competence cognitive development), better needed resources, make involved in policy council);
Greater knowledge of child health, approaches toward informed decisions, articulate More peer support among
development and parenting (age learning (increased curiosity, able and reach goals, advocate for parents
appropriate expectations; good to conquer new challenges, able the family, achieve economic
parenting skills) to remember prior experiences self-sufficiency)
and relate to current tasks) More supportive home
environment
L Parent-child relationships Physical development/health Physical health, mental health Staff competencies, teamwork Quality of community child
Parental knowledge of child Cognitive, social-emotional, and healthy family and morale, and career care, quality of other
1997
development physical, and school readiness functioning, self-sufficiency, development community services, and
Attachment, knowledge of child literacy and education, and involvement of parents in the
development, understanding the father involvement community
parent-child relationship, and
parenting
1999 Parent-child relationships Physical development/health Physical health, mental health Staff competencies, teamwork Quality of community child
Parental knowledge of child Cognitive development, social- and healthy family and morale, and career care, quality of other
development emotional development, school functioning, self-sufficiency, development community services, and
Attachment, parenting readiness literacy and education, and involvement of parents in the
father involvement community
M Parent-child relationships Social-emotional and approaches Economic self- Staff development not Quality of community child
Attachment, knowledge of child toward learning sufficiency/employment discussed during site visit care
1997
development, and understanding the Mental health and healthy Involvement of parents in the
parent-child relationship family functioning community
1999 Stronger parent-child relationships Enhanced child health and Greater economic self- Better knowledge about and Higher quality of community
Stronger attachment, enhanced physical development sufficiency and more implementation of Head Start child care
knowledge of child development, Enhanced language employment and education Program Performance Greater involvement of
better understanding of the parent- development (overarching), Healthier family functioning, Standards, High-quality parents in the community,,
child relationship enhanced social-emotional and better physical and mental performance and ability to more community service
development, stronger health reflect on program goals provider collaboration
approaches toward learning,
enhanced cognitive
development
N Knowledge of child development and Language development Economic self- Teamwork and morale and Coordination of services
parenting Language, social-emotional, sufficiency/employment career development Quality of community child
1997
physical, approaches toward Mental health and healthy care
learning, and knowledge of their family functioning, self-
community and diversity sufficiency, home
environment, and father
involvement
TABLE III.1 (continued)
Programs Parent-Child Relationships Child Development Family Development Staff Developmentb Community Buildingb
1999 Increased knowledge and practice of Babies are healthier and display Increased awareness and use Obtain advanced degrees; Higher child care quality
positive parenting strategies developmentally appropriate of community resources receive salaries comparable to (age appropriate activities,
(especially discipline, setting firm growth (in all areas—cognitive, Improved self-esteem; other child development nurturing staff), stronger
limits) self-help, language, motor, improved ability to articulate programs and schools support for EHS in
Increase parent-child bond and social-emotional, intellectual feelings and appropriately deal community
responsiveness to children development) with conflict; greater
Ability to express needs and knowledge of resources and
wants positively by gestures and make progress toward own
words goals; Greater motivation to
improve standard of living;
higher educational attainment;
greater knowledge of
community and cultural
diversity (develop sense of
pride, recognize roots and
share with children and
community, more involved in
community, better
understanding of all cultures in
the community)
O Parenting stress Physical development and health Physical health, mental health Staff competencies and career Collaboration
Knowledge of child development and Cognitive, language, social- and healthy family development Quality of other community
1997
parenting emotional, physical, and functioning, self-sufficiency, services, coordination of
approaches toward learning and home environment services and collaboration,
and involvement of parents
in the community
1999 Enhanced parent-child relationships Social-emotional development Self-sufficiency (improved life Increased staff competencies Increased quality of
Increased knowledge of child (self-control, social skills) skills, social skills, and (better trained); career community child care;
development and parenting Language development advocacy for self and development (better educated) enhanced coordination of
(realistic expectations, reduced (communication skills, self- children) (progress toward services and collaboration
child abuse, read to children more expression), cognitive employability, improved (increased collaborative
often, increased confidence in development (prepared for housing, increased planning work style when staff move
parenting, use appropriate reading) skills, better financial to other agencies); increased
discipline techniques, follow management skills) awareness about importance
routines with children) Improved physical health of early child development
(reduced substance abuse and
smoking, better nutrition);
improved mental health and
healthier family functioning
(healthier lifestyle, reduced
social isolation); safe home
environment
TABLE III.1 (continued)
Programs Parent-Child Relationships Child Development Family Development Staff Developmentb Community Buildingb
P Attachment, knowledge of child Language development Physical health, mental health Staff competencies, teamwork Quality of community child
development, and parenting Social development and healthy family and morale, and career care
1997
Cognitive, language, social- functioning, self-sufficiency, development Quality of community child
emotional, and physical and home environment care, coordination of
services and collaboration,
and involvement of parents
in the community
1999 Stronger attachment ; enhanced Enhanced cognitive development Enhanced physical health; Enhance staff competencies Higher quality of community
knowledge of child development; Enhanced language development better mental health; healthier (getting CDAs, relationship child care
better parenting Enhanced social-emotional family functioning, greater building, cultural sensitivity); More coordination of
development (empathy, social self-sufficiency; enhanced more teamwork and better services and collaboration;
skills) home environment, greater morale; stronger career greater involvement of
Enhanced physical development independence/ self- development parents in the community
(reduced severity of injuries and determination/ self-confidence
illnesses)
Q Parent-child relationships Social-emotional and physical Mental health and healthy Teamwork and morale Quality of community child
Parental knowledge of child family functioning and self- care
1997
development sufficiency Quality of other community
Attachment, knowledge of child services, coordination of
60
development, and parenting services and collaboration,
and involvement of parents
in the community
1999 Parent-child relationships (secure Age-appropriate levels of social- Families’ abilities to set goals Professional development and Service coordination and
attachment) emotional and physical Mental health and coping advancement collaboration (especially for
Parental knowledge of child development skills; self-sufficiency; healthy transitions); involvement of
development (especially realistic family functioning (goal- parents in the community
expectations) setting, focus on change);
social support (especially for
parenting)
NOTE: In 1997, programs were limited to identifying three priority outcomes; in 1999, several programs named more than three.
a
The entries under each cornerstone indicate the key areas in which each program indicated important outcomes in the theories of change discussions during the fall 1997 and fall 1999 site
visits. The outcomes highlighted in italics are the programs’ “priority” outcomes.
b
Due to time constraints, this cornerstone was not discussed during some 1997 site visits.
this chapter discusses and summarizes these expected outcomes, the ways they have changed
over time, and the implications they have for understanding program development and impacts.
B. EVOLUTION IN PROGRAMS’ EXPECTED OUTCOMES
We describe programs’ priority outcomes in two ways. First, we consider the extent to
which the programs, as a group, were focusing on particular areas. To do this, we report the
priority outcomes that fell into each area as a percentage of all priority outcomes. This is shown
in part A of Table III.2. Next, we look at the number and percentage of programs that focused
on particular types of outcomes. These are shown in part B of Table III.2.
1. Specific Changes That Occurred in Programs’ Focus on Priority Outcomes in
Particular Areas
While a small number of programs did not change the priority outcomes identified in May
1998, the focus of most programs became refined and/or modified in important ways over time,
reflecting changing views of the important outcomes they wanted to achieve. As shown in part
A of Table III.2, the proportion of priority outcomes that were in the areas of parent-child
relationships and child development did not change: in 1998, 59 percent of the priority outcomes
were in the combined area of parent-child relationships and child development, and this
combined area comprised 60 percent of the outcomes in 1999. It is important to consider child
and parent-child relationships together, for, as we learned in discussions with program staff,
programs often stress parent-child relationship goals because of the expected effects they will
have indirectly on children’s development.
Family development outcomes became a larger proportion of all the priority-expected
outcomes in 1999 than they were in 1998, rising from 16 to 27 percent. At the same time, a
substantially smaller proportion of the total expected priority outcomes were in staff
61
TABLE III.2
EARLY HEAD START PROGRAMS’ PRIORITY OUTCOMES
A. Percentage of Priority Outcomes in Each Area, 1998 and 1999.2
Area 1998 1999
Parent-Child Relationships 37 34
Child Development 22 26
Family Development 16 27
Staff Development 12 8
Community Building 14 5
Note: When child development and parent-child relationships are considered together,
they account for 59 percent of all priority-expected outcomes in 1998 and 60 percent in
1999.
B. Number (and Percentage) of Programs with Priority Outcomes in Each Area, 1998 and
1999
Area 1998 1999
Parent-Child Relationships 13 (76) 14 (82)
Child Development 9 (53) 11 (65)
Family Development 8 (47) 13 (76)
Staff Development 6 (35) 5 (29)
Community Building 7 (41) 3 (18)
Note: When child development and parent-child relationships are considered together,
five programs (29 percent) identified outcomes in both areas in 1998 and nine (53
percent) did so in 1999.
2
The reason the two analyses shown under A and B appear somewhat different is that each
program could (and often did) identify multiple outcomes in one area. Since programs were limited
to naming three priority outcomes, the total number of priority outcomes is fixed and the percentage
of outcomes in each area must equal 100 percent. In contrast, because programs could name priority
outcomes in multiple areas, the percentage of programs that named priority outcomes in each area
can sum to more than 100 percent across the five areas.
62
development and community building—together these areas constituted about a quarter of all the
priority outcomes (26 percent) in 1998. However, staff and community development became
even less likely to be priority outcomes in 1999, constituting only 13 percent of all priority
outcomes that programs reported to us.
Looking at the percentage of programs with priority outcomes in each area (part B of Table
III.2), it is clear that an increasing number of programs were working toward outcomes in the
parent-child, child development, and family development areas in 1999, compared with 1998.
At the same time, fewer programs in 1999 than in 1997 considered staff development and
community building to be among their priority outcomes. We should point out, however, that
the lowered priority for outcomes in these areas did not mean that programs were neglecting staff
and community development. We continued to see strong programmatic efforts in these areas, as
noted in chapters V and VI. Rather, programs were undoubtedly responding to guidance from
the Head Start Bureau and articulating the choices they made when it was not possible to have
every area be high priority.
We examined, from the program perspective, the nature of these changes. First, two
programs that did not identify parent-child relationships as a priority outcome in 1998 added that
focus in 1999. One program dropped its parent-child priority focus, which yielded a net increase
to 14 programs with priority outcomes in that area. A similar change occurred in child
development. Three programs added it as a priority focus, while one program dropped it, which
resulted in a net increase from 9 to 11 programs that placed child outcomes among their top
priorities.
Another pattern of change was that, over time, programs with priority outcomes in staff
development and community building shifted focus to outcomes in the family development area.
Five programs added priority outcomes in that area, and no programs that identified family
63
development outcomes in 1998 dropped them, which resulted in an increase from 8 to 13
programs identifying such outcomes.
One program added expected outcomes in staff development, and two no longer identified
staff outcomes in 1999, which resulted in a net decrease from six to five programs that were
giving priority to that area. Substantial change among priority outcomes occurred in the
community area, however. Four programs that had identified priority outcomes in this area in
1998 no longer did so in 1999, and no program added this as a priority focus. Thus, in 1999
three programs had community building as a priority focus (compared with seven in 1998).
Three of the programs that no longer identified community outcomes as priority added family
outcomes.
The evolution of expected outcomes also involved changes in program thinking within each
of the five areas. For example, in the child development area, programs identified specific
aspects that they focused on, as shown in Table III.3. Among the 11 programs identifying child
development priority outcomes in 1999, subsets of programs focused on the following specific
outcomes:
• Five programs specified social-emotional development
• Five programs specified cognitive development (or both cognitive and language
development)
• Two programs specified language development
• Three specified health and physical development
• Two named generic child development outcomes (for example, “achieving
appropriate developmental milestones”)
64
TABLE III.3
EVOLVING PRIORITIES WITHIN THE CHILD DEVELOPMENT AREA:
NUMBER (AND PERCENT OF PROGRAMS IDENTIFYING EACH ASPECT
OF CHILD DEVELOPMENT AS A PRIORITY OUTCOME
Child Development Outcome 1998 1999
Social or social-emotional
development 3 (33) 5 (45)
Cognitive development 3 (33) 5 (45)
Language development 4 (44) 2 (18)
Health and physical development 2 (22) 3 (27)
Generic child development 0 (0) 2 (18)
Total programs with child
development outcomes 9 11
Thus, a somewhat greater proportion of programs had a priority to achieve social-emotional
and cognitive outcomes in 1999 (compared with 1998), and a smaller percentage identified
language as a priority child development outcome.
2. Changes Across All Expected Outcomes Between 1997 and 1999
In addition to considering the priority outcomes, we also documented all outcomes that
programs deemed “important.” These are shown in Table III.1, along with the 1997 and 1998
outcomes. One of the first things to note is that every program identified outcomes in all areas.
This was an important first step for programs as they attempted to implement all four program
areas as specified in the original program grant announcement.
A number of programs reported more-detailed outcomes in 1999 than in 1997; several
programs have become more detailed in their identification of outcomes in parent-child
65
relationships, child development, and family development. Both in 1997 and 1999, all programs
identified social-emotional outcomes as ones they expected to achieve. Thirteen programs
identified cognitive outcomes (a slight increase from 12 in 1997), and 11 expected language
outcomes (increased from 9 in 1997). The largest increase occurred in the area of health and
physical development, where 15 of the 17 programs mentioned these outcomes in 1999, in
contrast to 11 in 1997.
3. Summarizing Programs’ Expected Child and Family Outcomes
One complication of our variable approach to discussing expected outcomes is the variation
in terminology. Programs reported both “important” and “priority” outcomes in 1997, 1998, and
1999. We have also shown the changes in programs’ expected outcomes over time, combining
priority and other outcomes, and combining information across years. Because no single
approach or point in time yields an exact picture of programs’ expected outcomes, we created a
composite index derived from (1) 1997 expected outcomes; (2) 1998 priority outcomes; (3) all
expected outcomes programs described in the fall 1999 site visits; and (4) priority expected
outcomes from 1999, as confirmed by local researchers.
If an outcome area was identified in at least three of these four analyses, we considered there
to be a “consensus” that it was a legitimate expected outcome of the program and could be the
basis for targeted subgroup impact analysis.2 The resulting clustering of programs is shown in
Table III.4. The largest number or programs (12) expected parent-child relationship outcomes.
Within child development, the most common expected outcome was social-emotional
development. Looking across the four child development areas, 10 programs indicated expected
2
Note that for the purpose of these analyses, we focus on the child and family outcomes, as
the study design does not allow for impact analyses of staff and community outcomes.
66
outcomes in at least one child development area, 7 identified two of the four areas, and 4
reported that they expected to achieve outcomes in three or all four of the areas.
4. The Relationship Among Expected Outcomes, Program Approaches, and Program
Impacts
The programs’ expected outcomes shown in Table III.4 are generally consistent with the
types of services they offered at the time of the 1997 site visits. In general, as shown in Figures
III.1 and III.2, center-based programs were more likely to emphasize child development
outcomes, while home-based programs were more likely to invest their efforts in enhancing
parent-child relationships and parenting/home environment outcomes (which they expected to
lead to impacts on children’s development later). Among programs that gave priority to parent-
child relationship or parenting outcomes, mixed-approach programs were most likely to
emphasize enhancing parent-child relationships (Figure III.1). Many home-based programs also
explicitly emphasized parent-child relationships, while others focused on aspects of parenting
and the home environment, such as increasing parents’ knowledge of child development or
encouraging parents to spend more time with their children.
We also examined the expected outcomes within child development (Figure III.3). Among
programs that gave priority to child development outcomes, the percentage of center-based
programs emphasizing cognitive and social-emotional development was equal (50 percent), and,
mixed approach and home-based programs were more likely to emphasize social-emotional
development.
Interim findings of program impacts through the children’s second birthday were
generally—but not completely—consistent with the program approaches and expected outcomes
(ACYF 2001). All program approaches resulted in positive benefits for children, but the types of
impacts differed across approaches. Center-based programs were the only ones to enhance
67
TABLE III.4
CLUSTERS OF PROGRAMS WITH PRIORITY OUTCOMES IN EACH ASPECT OF
CHILD AND FAMILY DEVELOPMENT
Programs in Cluster
Area Specific Outcome Number Percent
Parent-child Parent-child relationships 12 71
relationships Knowledge of child 6 35
development
Child development Social-emotional development 7 41
Cognitive development 5 29
Language development 4 24
Physical development and 3 18
Health
Family development Family self-sufficiency 11 65
Family mental health 6 35
68
FIGURE III.1
VARIATION IN PROGRAM APPROACH AMONG PROGRAMS WITH
DIFFERENT PRIORITY OUTCOMES
100
90
80
Percentage of Programs
70
60
69
50
40
30
20
10
0
Child Development Parent-Child Relationships Parenting Knowledge/Home Family Mental Health
Environment
Priority Expected Outcomes
Center-Based Mixed-Approach Home-Based
FIGURE III.2
PRIORITY EXPECTED OUTCOMES BY PROGRAM APPROACH
100
90
80
70
Percentage of Programs
70
60
50
40
30
20
10
0
Center-Based Mixed-Approach Home-Based
Child Development Parent-Child Relationships Parenting Knowledge, Home Environment Family Mental Health
FIGURE III.3
PRIORITY EXPECTED CHILD DEVELOPMENT OUTCOMES, BY PROGRAM APPROACH
100
90
80
70
Percentage of Programs
60
71
50
40
30
20
10
0
S ocial-Emotional Cognitive Language Health/Physical
Priority Expected Outcomes
Center-Based Mixed-Approach Home-Based
children’s cognitive development significantly, while home-based programs improved children’s
language development and mixed-approach programs improved both language and social-
emotional development. Early Head Start impacts on parenting and the home environment were
concentrated in home-based and mixed-approach programs (with a few exceptions).
C. PERSPECTIVES FROM THEORY-OF-CHANGE DISCUSSIONS AMONG
RESEARCHERS AND PRACTITIONERS
A special feature of the Early Head Start Research and Evaluation project has been the
presence of local research teams to work with 16 of the 17 programs. As noted earlier,
researchers to varying degrees in different locations engaged their program partners in
discussions of expected outcomes and theories of change. In this section, we highlight the
theory-of-change work within the Early Head Start programs and between the program and
research staffs in the local partnerships.
1. The Value of Research-Program Partnership in Developing Theories of Change
The experience of the research-program partnership at the Bear River Early Head Start
program in Logan, Utah, illustrates how this process can occur and what the benefits may be for
both the programs and the researchers and, ultimately, for the children and families. Lori
Roggman, the local researcher at Utah State University, who has worked with the Bear River
staff from the beginning of Early Head Start, noted that even though program staff members
often do not articulate a “theory of change,” they develop strategies for working with families
based on a general philosophy or “theory” about how to make changes in the lives of families
and children. Dr. Roggman has served as the continuous program improvement partner with the
Bear River staff. This program, serving rural and semirural areas in and around Logan, Utah,
emphasized home visits as a critical element in their theory of change. The process and the
outcomes of the theory-of-change discussions in Utah reveal the importance of an active,
72
interactive process. Although there may be many ways in which theory-of-change discussions
between researchers and program staff might unfold, this provides an example of how the
process developed in one site.
2. Voices of the Staff: Home Visitors Describe Their “Theories of Change”
Frontline staff members in Early Head Start programs are dedicated to their jobs and to their
families (see discussion of Early Head Start staffing in Chapter V). Sometimes, even when staff
members are not explicitly discussing a “theory of change,” as they did in Utah, they often reveal
an implicit theory of change when they talk about their families and the successes their families
have achieved. An example appears in the next box, taken from the words of a home visitor with
the Community Action Agency Early Head Start program in Jackson, Michigan.
3. Local Variations in the Development of Program Theories of Change3
Susan Pickrel, a local researcher with the Sumter, South Carolina, Early Head Start program,
led a cross-site effort to learn about the ways in which program staff think about and articulate
their theories of change. Local researchers in nine of the research sites held discussions with
their program partners in 1999-2000, following a standard set of questions. Questions asked
about program successes and outcome areas in which the program was less than successful.
They audiotaped the discussions and transcribed the tapes, and Pickrel’s South Carolina team
coded the discussions. The coding identified the key concepts that program staff used in
describing barriers to and facilitators of success in working with their families. Through this
process, researchers gained greater understanding of the programs’ theories as to how changes in
3
This section was contributed by Susan G. Pickrel, a local researcher working with the
Sumter, South Carolina, Early Head Start program, who is currently with the Mercy Medical
Center in Roseburg, Oregon.
73
Creating a Theory of Change at Bear River Early Head Start, Logan, Utah
Lori A. Roggman
Utah State University
The first time I, as the local researcher, talked about a “theory of change” with the staff at Bear River Early
Head Start, I asked two questions: “How will families who are in your program end up different from those who
are not in your program?” and “How exactly will this program make that happen?” In response to the first, staff
had a long list of outcomes they believed would be changed by their program. They believed the families in the
program would be happier parents with happier babies. They believed parents would be more knowledgeable and
less stressed and feel better about themselves as parents. They believed the babies would be healthier, happier,
more secure, and smarter. The second question was more difficult. After a long pause, someone said, with
conviction, “Because we believe in this program and we believe in these families.”
Through weeks of training, staff who were about to begin making home visits to families learned about child
development, the Head Start Program Performance Standards, infant and family health, social services, and how to
do all the necessary documentation. They had learned how to use the lesson plan forms and how to fill out forms
for mileage reimbursement. They understood the research design and believed that the children and families in
Early Head Start would end up better off in many ways. But they lacked a clear idea of the actual mechanisms of
change. They knew they were supposed to make home visits to parents, and they knew how parents and infants
were supposed to be affected by the program, but they did not seem to have a clear idea of how exactly one
connected to the other. The authors of the program’s grant proposal had a clear vision of the program, but those
who would have the responsibility for working directly with families weren’t seeing it as clearly.
Since then, the Early Head Start staff members have worked together to write (and regularly review and
revise) a “theory of change.” By clearly specifying “how families will end up different” and “how exactly this
program will make that happen,” staff described a “vision” that then guided their decision making. For example,
for their primary goal, “to increase positive parent-infant play interactions, nurturant and responsive parenting, and
parents’ knowledge about child development,” staff identified a specific strategy: that three-fourths of home visit
time will be spent in “direct play interactions to enhance the parent-child relationship.” The vision that guides
program activities also guided the researchers to focus their evaluation on staff-parent relationships.
Bear River Early Head Start staff members have described home visits and the role of home visitors with
increasing clarity over the years. From Year 1 to Year 2, descriptions of home visits shifted toward a more-active
intervention process that emphasized direct interactions between parents and infants (instead of interactions that
were primarily discussions with parents). From Year 2 to Year 3, the descriptions shifted toward a greater
emphasis on father involvement and family independence that involved helping both mothers and fathers plan
their own activities with infants, both during home visits and between home visits.
By writing a description of the connections between staff activities and what happens to families, the
program was able to get off to a good start serving families with infants and toddlers. Beyond their self-
confidence, staff members had specific ideas about what strategies to use. By regularly reviewing and revising
this written “vision,” the program is able to continue improving and fine-tuning its efforts.
74
A Home Visitor’s View of Her Family’s Successes
Christina Katka
Community Action Agency Early Head Start
Jackson, Michigan
Carol (not her real name) called to request early intervention services for her 27-month-old son, “Jack,” who
had been born prematurely, at just under 5 pounds. The toddler was receiving speech therapy from the local
children’s hospital and participating in Part C services. Jack lives with Carol, his father, Peter, and a 14-year-old
brother. This family’s situation is unusual—entering Early Head Start with less than a year of services possible—
but enrollment was considered important, given the needs of the child and the family.1 Carol is herself disabled,
from burns suffered as a child; Peter works full-time at a local university and part-time as a sheriff.
Jack appeared small, shy, and guarded during our first meeting. He was easily frustrated, experiencing
difficulty in expressing his wants and needs. As he became more familiar with me, his energy level increased. He
actively engaged me in his play. And Jack often gave me a sense of “invitation” to “join” him in his world, a special
place for a sensitive, loving child.
During our home visits, both parents talked openly about their concerns and worries about Jack’s development.
I realized I needed to begin with an alliance that offered Carol a strong and consistent relationship. I attempted to
nurture and respect the family and be sensitive to their needs, providing a weekly presence in their home. I also felt
they needed information, so I provided some on child development and age-appropriate toys, and offered help with
guided activities that would enhance Jack’s large and small muscles. I introduced information about self-help skills,
as well as cognitive development and the opportunity to use weekly play that would facilitate positive parent-child
interactions. I was encouraged that the family also joined in on biweekly socialization groups, where Jack began to
interact with other children—first in individual play, then in parallel play, and finally in cooperative play.
I eventually began to see the results of these interactions. Carol’s confidence improved, and Jack’s language
and communication developed. As Carol found the courage to face her fears, Jack found his own courage,
supported by his ever-present drive toward independence. His play became more organized as he used appropriate
exploration. Jack is affectionate, expressive, and interactive, while demonstrating a strong capacity for attachment
and trust. Carol, in addition to taking great pleasure in her son’s growth, is caring and compassionate, and provides
a safe, nurturing environment for Jack’s continuing development. Peter provides a strong male influence, providing
an active role model in Jack’s life. As Jack enters the Head Start preschool program in the fall, he is being placed in
the half-day inclusion classroom, where his new caregivers expect the progress we’ve seen in Early Head Start to
continue.
1
For participation in the research, programs enrolled families when children were 12 months of age or younger.
families come about. These elements related to (1) the characteristics of the mothers; (2) the
features of the program; and (3) the program process characteristics (operational features, staff
behavior, and staff-family interactions) that might relate to the outcomes expected within the
particular theory of change.
Six of the nine programs identified characteristics of the mothers as key to Early Head Start
program outcomes, and three considered the program or program process characteristics as key.
75
In other words, one-third were oriented toward taking responsibility for the success of Early
Head Start, independent of the participant characteristics. In the first set of programs,
responsibility for change was articulated to be such characteristics of the mother as (1) desire or
willingness to participate in the Early Head Start program, (2) focus on being a good parent, (3)
ability to see positive developmental changes quickly in her child, (4) readiness to receive
program information, (5) desire to make her and her child’s life better, and (6) enjoyment in
being with her baby.
When staff members mentioned program characteristics as the factors producing the change,
they tended to focus on generic features. Those programs features mentioned in more than one
site included (1) case management (six sites), (2) home visits (four sites), (3) center-based child
development services (three sites), (4) other child development services (two sites), and (5) on-
site medical/pediatric and dental assessments and information (two sites). Although, for coding
purposes, program characteristics were defined as static characteristics of a program (in contrast
to the process characteristics, which reflect activities that occur between two persons or
organizations), there was some overlap between the static and process characteristics. For
example, case management, home visits, and child development services mentioned by multiple
sites all involve interchanges between Early Head Start staff and program participants.
Characteristics were coded as process, however, only if the discussions directly described
personal process features rather than labels for program elements. The process elements listed
next make this distinction clearer.
The programs that identified program process characteristics indicated a “theory of change”
based on what program staff did to meet participant needs rather than on parent characteristics.
The program or process characteristics included such factors as (1) staff skills in mental health
interventions, (2) accepting and managing difficult behaviors in participants, (3) adapting to
76
parent and family circumstances, and (4) persistence in trying to establish a relationship with the
family in spite of obstacles.
Whether or not the dominant factors in the programs’ implicit theories of change were
characteristics of participants or of the program/program process, staff members at all nine
program sites mentioned process elements in their discussions. Those mentioned by staff at
three or more sites were:4
�� Building a relationship of trust with the mother (mentioned in all but one of the sites)
�� Providing support for mother or family (all but one site)
�� Educating (six sites)
�� Focusing on strengths (five sites)
�� Modeling (four sites)
�� Teaching and problem solving (four sites)
�� Working as a team (for Early Head Start staff) (three sites)
These discussions indirectly yielded a qualitative sense as to how well developed the staffs’
theories of change were. The emerging “theories” could be assessed in terms of the coherence of
the stories that Early Head Start staff generated and the manner in which staff used terms to
describe program success and nonsuccess. Coherence was judged by how clearly staff
articulated what their program activities were, why they conducted these activities, and how they
defined program success (the families’ responses to the Early Head Start intervention). Just as
the researchers evaluated staff discussion of barriers and facilitators in terms of characteristics of
the mother, the program, or the program process, the terms program staff used to describe
4
Twenty-four other process features were mentioned by just one or two programs each.
77
program successes could be categorized along the same dimensions. A program’s theory of
change was considered to be less well developed if the program described success only in terms
of characteristics of the mothers. Theories of change were considered better developed when
success was described in terms of both program and process characteristics.
Two of the nine programs were considered to have well-developed theories of change, two
had moderately well-developed theories, and four were judged to have underdeveloped theories.
In the two programs that had the best-developed theories of change, staff members went into
greater detail in describing the change process. One program detailed the relationship between
Early Head Start staff and the mothers, and then described how that resulted in specific child
development outcomes. The other program articulated a step-by-step process by which each
family achieved its success. When theories of change were judged to be less well-developed,
they failed to link important process factors (such as the staff-mother relationship) to the
program’s expected outcomes (such as child development) or failed to articulate the outcomes
clearly, or staff were inconsistent in describing the outcomes and process elements.
D. SUMMARY
Programs that wish to understand and communicate their goals and their strategies for
achieving them increasingly use theories of change. At the same time, researchers who desire to
understand better the programs they are evaluating adopt a theory-of-change approach so they
can target their analyses on the outcomes that are most important to the programs, and then be
better positioned to explain the results. In the Early Head Start evaluation, we have assessed
programs’ theories of change using a variety of methods across various points in the programs’
implementation. The Early Head Start research programs have been working toward outcomes
primarily in the areas of parent-child relationships, child development, and family development.
Within child development, the greatest priorities lie in the areas of social-emotional and
78
cognitive development, yet considerable variation exists across programs. Programs that are
center based tended to emphasize child development outcomes while those that are home based
were more likely to emphasize parent-child relationships and parenting outcomes. Mixed-
approach programs tended to emphasize parent-child relationship outcomes. This chapter has
illustrated the variety of perspectives that contribute to understanding programs’ theories of
change, based on discussions among research and program partners at various sites participating
in the national evaluation.
79
IV. PROGRAM IMPLEMENTATION: OVERALL LEVELS AND PATTERNS
This chapter and the three that follow report the levels and patterns of program
implementation in 1999, as well as the progress in implementation that programs made over
time. For these analyses, we defined the degree of implementation as the extent to which
programs offered services that met the requirements of the Early Head Start grant announcement
(U.S. Department of Health and Human Services 1995) and selected key elements of the revised
Head Start Program Performance Standards (U.S. Department of Health and Human Services
1996). We defined “full implementation” as substantially implementing, or exceeding
expectations for implementing, these key program elements.
We begin this chapter by describing our methods for measuring program implementation
and then summarize the progress programs made in their overall levels of implementation
between fall 1997 and fall 1999. In addition, we describe patterns in the timing by which
programs reached full implementation of particular program elements. Succeeding chapters
address implementation progress in broad program areas—child development and health services
(Chapter V), family and community partnerships (Chapter VI), and staff development and
program management systems. (Chapter VII).
A. MEASURING PROGRAM IMPLEMENTATION
To assess the extent of program implementation, we developed implementation rating
scales, checklists for organizing the information needed to assign ratings to programs, and a
rating process. We designed this rating system to help us reduce a large amount of information
on program implementation into summary variables for testing hypotheses about how
implementation relates to outcomes and to systematically analyze the research programs’
81
progress toward full implementation over time. This section describes our data sources, the
rating scales we developed, and the rating process we followed for assessing implementation.
1. Data Sources
For these analyses, we relied primarily on information collected during site visits conducted
in fall 1997 and fall 1999 and self-administered surveys completed by program staff at the time
of the site visits. To facilitate the systematic assignment of implementation ratings for each
program, site visitors assembled the site visit and staff survey information in checklists organized
according to key program elements of the performance standards (Appendix A). In addition, site
visitors wrote detailed program profiles based on information obtained during the site visits.
Program directors and their local research partners reviewed the profiles and checklists for their
programs, provided corrections of erroneous information, and in some cases provided additional
clarifying information.
2. Implementation Rating Scales
To develop implementation rating scales, we identified specific criteria for determining the
degree to which programs implemented Early Head Start’s three major program areas as defined
in the performance standards: (1) early childhood development and health services, (2) family
and community partnerships, and (3) program design and management. To refine our
assessment, we created distinct criteria for both family and community partnerships. Likewise,
within program design and management we created separate criteria for staff development and
program management systems.
The criteria encompass key program requirements contained in the Early Head Start grant
announcement and the performance standards. Because the purpose of the ratings was to
identify and track over time the implementation of key program requirements and not to monitor
82
compliance, we focused on key requirements needed to help us identify pathways to full
implementation and to summarize and quantify a large amount of qualitative information on
program implementation. We reviewed our initial criteria with representatives of the Head Start
Bureau and the Early Head Start technical assistance network to ensure that the criteria included
the most important subset of program requirements. We also solicited comments from members
of the Early Head Start Research Consortium. Table IV.1 summarizes the 25 program elements
we assessed in 1999, organized according to program area. The rating scales were slightly
different in 1997, but were revised based on the initial site visit experience. In 1997, we rated 24
program elements. The only differences were that in 1997 (1) follow-up services for children
with disabilities were rated as a part of developmental assessments (under child development and
health), (2) “father initiatives” was a separate rating element within family development
(whereas in 1999 it was included in parent involvement), and (3) in the area of management
systems, communication systems was not rated.
Prior to our fall 1997 site visits, we created a rating scale for each of the 24 program
elements. In 1999, we made some minor revisions to these scales to reflect clarifications in
program guidance from the Head Start Bureau and our evolving understanding of the
performance standards, which took effect after our fall 1997 site visits. The 1999 rating scales
are shown in Appendix B.1 Each rating scale contains five levels of implementation, ranging
from minimal implementation (level 1) to enhanced implementation (level 5) (Table IV.2). We
considered programs rated at level 1 through 3 to have reached partial implementation and
programs rated at levels 4 and 5 to have reached full implementation of the particular program
element rated.
1
The 1997 rating scales appear in Leading the Way, Volume III, Appendix B (ACYF 2000).
83
TABLE IV.1
PROGRAM ELEMENTS INCLUDED IN THE EARLY HEAD START
IMPLEMENTATION RATING SCALES—FALL 1999
Program Component Program Element
Child Development and Health Frequency of child development services
Developmental assessments
Follow-up services for children with disabilities
Health services
Child care
Parent involvement in child development services
Individualization of services
Group socializations (for home-based and mixed-
approach programs)
Family Development Individualized family partnership agreements
Availability of services
Frequency of regular family development services
Parent involvement
Community Building Collaborative relationships
Advisory committees
Transition plans
Staff Development Supervision
Training
Turnover
Compensation
Morale
Management Systems Policy council
Communication systems
Goals, objectives, and plans
Self-assessment
Community needs assessment
84
TABLE IV.2
EARLY HEAD START IMPLEMENTATION RATING SCALE LEVELS
Level Definition
Partial Implementation
1 Minimal implementation Program shows little or no evidence of effort to
implement the relevant program element.
2 Low-level implementation Program has made some effort to implement the
relevant program element.
3 Moderate implementation Program has implemented some aspects of the
relevant program element.
Full Implementationa
4 Full implementation Program has substantially implemented the relevant
program element.
5 Enhanced implementation Program has exceeded expectations for implementing
the relevant program element.
a
We use the term “full implementation” throughout this report as a research term to reflect our
judgment that a program had achieved a rating of 4 or 5. We recognize that programs not “fully”
implemented were nevertheless often implementing many features of the performance standards.
In addition, even when rated as “fully” implemented, programs may have been striving to do
more and be involved in continuous improvement activities.
85
3. Rating Process
Following each round of site visits, we used a consensus-based process to assign
implementation ratings to each Early Head Start research program. We assembled a rating panel
that included four national evaluation team members, a representative of the Early Head Start
technical assistance network, and another outside expert. For each program, three people—the
site visitor and two panel members—assigned ratings independently, based on information
contained in the checklists and the program profile compiled by the site visitor. Ratings were
assigned for each of the 24 (or 25 in 1999) program elements, the five program areas (as shown
in Table IV.1), and for overall implementation. In completing the ratings of overall
implementation, we established the following guidelines for creating the overall ratings based on
the ratings of the individual program components:
• Low-level Implementation: Programs that reached only a low level of
implementation had achieved moderate implementation in only one or two program
areas. Other programs areas were poorly or minimally implemented.
• Moderate Implementation: To achieve this rating overall, programs were (1) fully
implemented in a few program areas and moderately implemented in the other areas,
(2) moderately implemented in all areas, (3) moderately implemented in most areas
with low-level implementation in one area, or (4) fully implemented in every area
except child development and health services.
• Full Implementation: To be rated as fully implemented overall, programs had to be
rated as fully implemented in most of the five component areas. Reflecting the Head
Start Bureau’s focus on child development, panel members gave special consideration
to the rating of child development and health services, and weighted it more heavily
in arriving at their consensus rating of overall implementation.
• Enhanced Implementation: A program demonstrating enhanced implementation
was fully implemented in all areas and exceeded the standards in some of the
component areas.
After these independent ratings were completed for all programs, the panel met to review the
three sets of independent ratings, discuss differences in ratings across panel members, and assign
consensus ratings for each program. We checked the validity of the our 1997 ratings by
86
comparing them to independent ratings. After the Head Start Bureau completed its monitoring
visits to all 17 research programs in spring 1998, we asked a member of the monitoring team to
use information collected during the monitoring visits to rate programs using the rating scales we
developed. We did not provide the monitoring team member with our rating results or the
information we collected during site visits. The independent ratings assigned by the bureau’s
monitoring team member were very similar to those assigned by our rating panel, yielding an
indication that our ratings provide a valid assessment of program implementation.
B. PROGRESS IN OVERALL IMPLEMENTATION BETWEEN FALL 1997 AND
FALL 1999
By fall 1999, all but one of the research programs had been serving families for three years,
and the Head Start Bureau had monitored each one for compliance with the performance
standards, which went into effect in January 1998. Most programs had also received technical
assistance following monitoring. Consequently, ACYF expected that by fall 1999, programs
would be substantially in compliance with the performance standards, or very near compliance in
most areas.
Indeed, across all program areas, the research programs made great strides in implementing
Early Head Start between fall 1997 and fall 1999, with the number of programs rated as “fully
implemented” overall doubling from 6 to 12 over the two years (Figure IV.1).2 Of the 12
programs that achieved full implementation, two were rated as having an enhanced level of
implementation overall by fall 1999 (up from one in 1997). All five programs that had not
reached full implementation by fall 1999 had reached moderate implementation. In most cases,
2
Implementation ratings from 1997 site visits were first described in Leading the Way:
Characteristics and Early Experiences of Selected Early Head Start Programs, Volume III,
Program Implementation (ACYF 2000a). 1999 ratings are described in detail in Chapters V
through VII of the current report.
87
FIGURE IV.1
EARLY HEAD START
OVERALL IMPLEMENTATION RATINGS
Number
of Programs
14
Partial Implementation Full Implementation
13
12
11
10
10
9
8
8
7
6
5 5
88
5
4
3
3
2
2
1
1
0 0 0
0
1 2 3 4 5
Minimal Low-Level Moderate Full Enhanced
Implementation Implementation Implementation Implementation Implementation
Ratings
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 17 Early Head Start research programs.
Note: Overall implementation ratings represent the average rating across all the dimensions we examined. Programs rated as fully
implemented achieved full implementation in most of the dimensions we examined, but did not necessarily achieve full
implementation in every dimension.
they achieved moderate levels in child development and health services and moderate or higher
level in at least one other area. In 1997, in contrast, eight programs were rated as moderately
implemented, and three (with low ratings in multiple areas) were rated as poorly implemented.
C. PATTERNS IN THE TIMING BY WHICH PROGRAMS REACHED OVERALL
IMPLEMENTATION
The Early Head Start research programs made substantial progress in implementing key
areas of the performance standards between 1997 and 1999. Altogether, nearly three-quarters of
the research programs were rated as fully implemented within four years of being funded. Some
accomplished this level of successful implementation relatively quickly, while others took
longer. Three patterns characterize the implementation progress of the 17 research programs:
those that were “early implementers,” “later implementers,” and “incomplete implementers.”
The early implementers are those programs that were rated as fully implemented in fall
1997 and remained so in fall 1999. About one-third (six programs) were in this category.
Although these programs became fully implemented early in the evaluation period, they
continued to develop over the two years. For example, between 1997 and 1999 three of them
expanded the number of children and families they served. These early implementers
demonstrated how services for infants and toddlers can be expanded within their communities.
The later implementers are the programs that had not achieved an overall rating of “fully
implemented” in fall 1997 but reached that level by fall 1999. Six programs (another third) were
in this group. In many cases, these were programs that were well implemented in most areas by
1997 except child development and health, but improved their implementation of child
development and health services and reached full implementation overall by 1999.
Finally, five programs, which we refer to as the incomplete implementers, were not fully
implemented in fall 1997 and had not reached full implementation by fall 1999. In some cases,
89
the incomplete implementers did not meet the requirements for a rating of “fully implemented”
in child development and health services or in other areas but did provide strong family
development services. In every case, however, these programs had made strides in some areas,
even though they still faced important challenges.
A number of factors may explain why programs achieved different levels of overall
implementation at different rates. For one, experience serving infants and toddlers may have
helped some programs reach full implementation of Early Head Start more quickly. Among the
11 programs that had served infants and toddlers before, 5 were early, 4 were later, and 2 were
incomplete implementers. In contrast, of the six programs that were new or were Head Start
programs serving infants and toddlers for the first time, only 1 was an early implementer, while 2
were later and 3 were incomplete.
Low staff turnover during the first year—including turnover in leadership positions—also
appears to have been instrumental in helping programs reach full implementation more quickly.
Of the six programs with a staff turnover rate of 20 percent or higher during the year prior to fall
1997, only one was an early implementer, two were later, and three were incomplete. On the
other hand, among the 11 programs with staff turnover under 20 percent during the year prior to
fall 1997, five were early implementers, four were later, and two were incomplete implementers.
Later staff turnover does not appear to have been as important an influence on programs’
progress in becoming fully implemented.
Although the timing of reaching full implementation might be expected to vary
systematically according to program approach, that does not appear to be the case. Whether or
not programs became fully implemented within four years of funding, and whether they did so
earlier or later, does not appear to be related to their basic approach to serving families or
whether they changed their approach between fall 1997 and fall 1999. Each group of programs
90
defined by implementation pattern includes home-based, center-based, and mixed-approach
programs as well as at least one program that had changed its approach.
Some aspects of Early Head Start were easier to implement than others. Most programs
were able to implement a large number of program elements well by fall 1997 and continued
implementing them well in fall 1999. These “early strengths” include:3
• Individualization of Child Development Services. From the beginning, most
research programs were able to implement a strategy for individualizing child
development services according to the needs of children. A strength of the programs
was providing child development services to almost all children and families in their
native languages. Many programs also individualized services according to
children’s developmental assessments.
• Developmental Assessments. Most research programs selected instruments for
assessing children’s development and were successful in conducting assessments
with most enrolled children by fall 1997.
• Parent Involvement in Child Development Services. Most research programs were
fully involving parents in planning for child development services by fall 1997.
They did so by involving parents in their children’s developmental assessments,
reviewing the results with them, and using them to plan services. In center-based
programs, some parents also participated in parent committees that planned center
activities.
• Frequency of Parent-Child Group Socializations Offered. From the beginning,
most home-based programs offered the required group socializations each month.
However, although the programs offered these group socializations, attendance was
often low.
• Efforts to Include Fathers. Most programs made special efforts to involve fathers
and father figures in program activities. However, levels of participation in special
activities for fathers were often low. The involvement of fathers in Early Head Start
programs is explored in depth in Father Involvement in Early Head Start Programs:
Summary Report (Raikes et al. 2002).
• Collaborative Relationships. Most of the Early Head Start research programs
established many relationships, some based on formal written agreements, with other
service providers early in their development. These programs communicated
3
These program elements are defined and described in the implementation rating scales
contained in Appendix B.
91
regularly with other service providers to coordinate services for families and
participated in at least one coordinating group of community service providers.
• Staff Supervision. Two-thirds of the research programs had fully implemented staff
supervision requirements by fall 1997, and more than half were providing an
enhanced level of staff supervision by fall 1997. Supervisors in these programs were
conducting both group and individual supervision sessions and, partly from
observation of service delivery, providing feedback on performance.
• Staff Training. By fall 1997, two-thirds of the research programs were providing
staff training according to a plan based on assessment of staff training needs, and all
staff had received training in multiple areas. Most programs also encouraged staff
members to take advantage of national, state, and local training opportunities that
would equip them to provide high-quality services.
• Community Needs Assessment. Nearly all the research programs had fully
implemented the requirements for conducting community needs assessments by 1997
and continued to update them as required.
Many aspects of Early Head Start were more challenging to implement. Nevertheless, most
programs had implemented them well by fall 1999. These “later strengths” include:
• Health Services. Between 1997 and 1999, the number of research programs that had
fully implemented health services for children nearly doubled, and most programs
had fully implemented these services by fall 1999. All programs helped families
find medical homes for their children. By 1999, most programs were also tracking
receipt of health services to help ensure that children received all recommended
well-child examinations, immunizations, and needed treatments.
• Frequency of Child Development Services. Programs improved considerably over
time in completing the required schedule of home visits. By fall 1999, most research
programs with home-based services were completing an average of at least three
home visits a month with enrolled families, and all center-based programs offered
full-day, full-year child development services and child care.
• Individualized Family Partnership Agreements. By the second rating period, most
programs were creating individualized family partnership agreements with all or
most of their families and updating them as needed.
• Availability of Family Development Services. Over time, the number of research
programs that fully implemented requirements to make a wide range of services
available to families, either directly or by referral, and to follow up systematically to
ensure that families receive needed services, nearly doubled.
• Frequency of Family Development Services. By fall 1999, most programs were
meeting regularly with all or most families to provide case management services.
92
Many programs also provided some family development services on site and made
referrals to other community service providers.
• Advisory Committees. In 1997, some programs were still putting together
community advisory committees in health and other areas, or the committees had
formed but were not active. By 1999, most programs had established committees
that met regularly and provided advice on infant and toddler issues.
• Transition Planning. Early on, most research programs did not focus on planning
for children’s transitions to preschool when they left Early Head Start. By 1999,
however, children were beginning to transition out of the program, and most
programs had procedures in place for planning with families for children’s
transitions.
• Staff Compensation. By 1999, more than half the Early Head Start research
programs reported that staff salaries and benefits were above the average for similar
community programs. Several programs were still in the process of increasing salary
scales and revising them to reward staff who obtained associate’s degrees.
• Staff Morale. Staff in the research programs generally reported a very positive view
of their workplace. Based on site visits and staff reports, morale appeared to be very
high in half the programs.
• Policy Council. Initially, only half the research programs had fully implemented
Policy Council requirements, but by 1999, nearly all had established Policy Councils
that included parents and community members and met regularly to make key
decisions about the program.
• Goals, Objectives, and Plans. Initially, many programs had not formally set goals
and objectives, nor had they developed written implementation plans. By 1999,
however, most programs had set or updated their goals and objectives and developed
written implementation plans.
• Self-Assessment. In 1997, one-third of the research programs had conducted an
annual assessment of their progress toward their goals and of their compliance with
the Head Start Program Performance Standards. By 1999, the proportion of programs
that had conducted a self-assessment in consultation with Policy Council members,
parents, staff, and other community members doubled.
93
A third group of program elements appears to represent “ongoing challenges” for Early
Head Start programs. Three elements were particularly challenging to implement, and the
majority of programs had not fully implemented them by fall 1999.4 These are:
• Child Care. Many Early Head Start parents were employed and needed child care
services. Programs that offered center-based services were able to meet the child
care needs of families more easily than were home-based programs. Home-based
programs made considerable progress in developing child care options that meet the
performance standards, and some even added their own center-based services.
Despite progress from 1997 to 1999, however, few home-based or mixed-approach
programs could ensure that the child care attended by “all or nearly all” Early Head
Start children was of high quality. Helping parents arrange high-quality child care
and working with child care providers to meet the quality standards in the Head Start
Program Performance Standards remains a challenge.
• Parent Involvement5: Although all programs offered opportunities for parents to
participate in program governance, many offered opportunities for parents to
volunteer, and many worked hard to involve fathers, only a few were able to involve
most parents in some capacity. In part because of welfare reform, many parents
were working and finding it difficult to make time for volunteering and participating
in other program activities.
• Staff Retention: Like child care programs in general, many of the Early Head Start
research programs struggled to retain frontline staff, and in both 1997 and 1999,
experienced staff turnover rates of 20 percent or more. Although most programs did
not achieve low turnover rates by 1999, the number of programs that experienced
very high turnover rates did decline.
The following chapters explore the levels and patterns of program implementation in more
depth and describe the factors that influenced program implementation.
4
Although health services were among the program elements that programs implemented
well by fall 1999, one aspect of these services, namely mental health services, presented an
ongoing challenge. Shortages of mental health services in the community made it very difficult
for programs to link all families to mental health services they needed.
5
This excludes involvement in child development services but includes volunteering, serving
on Policy Councils, and participating in parent committees.
94
V. PROGRESS IN IMPLEMENTING KEY CHILD DEVELOPMENT
AND HEALTH SERVICES
Early Head Start and Head Start programs are designed to promote healthy development
during children’s early years. In the revised Head Start Program Performance Standards, the
Head Start Bureau lays out specific Head Start and Early Head Start program requirements for
achieving this overall goal.1 In the domain of child health and development, the standards
specify the following types of services, designed to ensure that the services are of high quality:
• Child health services, including assessments of health status; developmental, sensory,
and behavioral screenings that involve parents and enable staff and parents to
individualize services for the child; and plans for followup and treatment of health
conditions
• Education and early childhood development services, including developmentally
and linguistically appropriate services that include children with disabilities, involve
parents, and support children’s development in a range of domains
• Child nutrition services, including assessments of nutritional needs, meals and snacks
in center-based settings and/or during group socialization activities, and nutrition
education
• Child mental health services, including assessments of children’s behaviors,
consultations with mental health professionals to address mental health concerns, and
education of parents and staff on mental health issues
In developing implementation rating scales, we focused on selected elements of the
standards. We rated each program’s level of implementation of the following key aspects of the
performance standards and program guidelines pertaining to child health and development:
• Developmental assessments
• Individualization of child development services
1
Throughout this chapter we quote appropriate sections of the standards. For the complete
performance standards, go to http://www.acf.hhs.gov/programs/hsb/performance/index.htm.
95
• Parent involvement in child development services
• Group socializations
• Child care
• Health services
• Follow-up services for children with disabilities
• Frequency of child development services
To be rated as “fully implemented” overall in child development and health services,
programs had to be rated as fully implementing services (that is, substantially implementing the
relevant program element) in most of these dimensions. In this chapter, we review the progress
the Early Head Start research programs made in implementing child development and health
services in relation to the requirements of the performance standards.
The number of programs rated as fully implementing Early Head Start child development
and health increased slightly between fall 1997 and fall 1999. By fall 1999, 9 of the 17 research
programs were fully implementing services in this area (Figure V.1), compared with 8 in 1997.2
The following sections tell the story behind this progress as we describe activities in each of the
eight aspects that the implementation study examined.
2
Although nearly all the programs improved their implementation of child development and
health services between 1997 and 1999, clarifications in program guidance from the Head Start
Bureau led us to revise the rating scales in this area, so that, in effect, the “bar” for full
implementation was raised between 1997 and 1999. Most notably, the 1999 rating scales require
a higher number of completed home visits per month for a rating of “fully implemented” on that
dimension and require that most families participate in group socializations regularly to attain a
“fully implemented” rating on that dimension. See Appendix Table A.1 for a detailed
description of the changes in the rating scales between 1997 and 1999.
96
FIGURE V.1
EARLY HEAD START CHILD DEVELOPMENT SERVICES
IMPLEMENTATION RATINGS
Number
of Programs
17 Partial Implementation Full Implementation
16
15
14
13
12
11
10
9
8 7 7 7
7 6
97
6
5
4 3
3 2
2 1 1
1 0 0
0
1 2 3 4 5
Minimal Low-Level Moderate Full Enhanced
Implementation Implementation Implementation Implementation Implementation
Ratings
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 17 Early Head Start research programs.
Note: Implementation ratings for child development services represent the average rating across all the dimensions we examined. Programs rated as fully
implemented achieved full implementation in most of the dimensions we examined, but did not necessarily achieve full implementation in ever
dimension. The 1999 ratings are based on revised rating scales that reflect clarifications in program guidance from the Head Start Bureau between
1997 and 1999.
A. DEVELOPMENTAL ASSESSMENTS
The revised Head Start Program Performance Standards require programs to conduct
periodic assessments of children’s motor, language, social, cognitive, perceptual, and
emotional skills.
The most common tools the research programs used to assess children’s development were
the Ages and Stages Questionnaires (ASQ), the Denver II Developmental Screening Test (DDST
II), the Early Learning Accomplishment Profile, and the Hawaii Early Learning Profile (Figure
V.2). Between fall 1997 and fall 1999, more programs adopted the ASQ and DDST II.
Programs indicated that they used the ASQ because they are parent-friendly and facilitate parent
participation in the assessment process; some adopted the DDST II because they believed it
facilitated working with early intervention service providers (the Part C agency) to identify
children with disabilities.
By fall 1999, most of the research programs (14 of the 17) had fully implemented
developmental assessments as required (up from 10 programs in fall 1997) (Figure V.3). In fact,
11 research programs had reached an enhanced level of implementation in this area: all staff
who worked with a child used that child’s developmental assessment results to plan services for
the child and the family. Three research programs were rated as achieving a moderate level of
implementation of developmental assessments, because they had given most children (but fewer
than 90 percent) a developmental assessment during the year preceding the site visit.
B. INDIVIDUALIZATION OF CHILD DEVELOPMENT SERVICES
The revised Head Start Program Performance Standards require programs to implement
child development services in a way that respects children’s individual rates of
development, temperament, gender, culture, language, ethnicity, and family composition.
All the research programs had fully implemented a strategy for individualizing child
development services by fall 1999 (up from 14 programs in fall 1997). Many programs (15) had
reached an enhanced level of implementation in this area by fall 1999. These programs provided
98
FIGURE V.2
TOOLS USED BY EARLY HEAD START RESEARCH PROGRAMS
TO ASSESS CHILDREN'S DEVELOPMENT
Number of Programs
17
16
15
14
13
12
11 10
10 9
9
8
7 6 6
6 5
5 4
4 3 3 3
3 2
2
1
0
ASQ DDST II ELAP HELP Other
Developmental Assessment Tools
Fall 1997 Fall 1999
ASQ = Ages and Stages Questionnaires.
DDST II = Denver II Developmental Screening Test.
ELAP = Early Learning Accomplishment Profile.
HELP = Hawaii Early Learning Profile.
SOURCE: Information gathered during visits to the Early Head Start research programs in fall 1997 and fall 1999.
99
FIGURE V.3
EARLY HEAD START CHILD DEVELOPMENT SERVICES
Number of Programs
ASPECTS THAT WERE FULLY IMPLEMENTED
That Reached Full
Implementation
17
17
16
15
15
14 14
14
13
13
12
12
11
11
10 10
10
9
9
8
8
100
7
7
6
6
5
5
4
3
3 No
2 Rating
in 1997
1
Developmental Individual- Parent Group Child Care Health Frequency Follow-Up Services
Assessments ization Involvement Socializationsa Services of Services for Children with
in Child Disabilities
Development Aspects of Child Development Services
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 17 Early Head Start research programs.
a
The rating scales in these areas were changed significantly between 1997 and 1999 to reflect clarifications in guidance from the Head Start Bureau. To the rating
scale for group socializations we added the requirement that most families participate in group socializations on a regular basis. We also increased the number of
home or center visits required for a "fully implemented" rating on frequency of child development services from two to three times per month.
child development services to almost all children and families in their own language, usually
Spanish or English. In some cases, programs provided services in three or more languages.
The research programs used a variety of strategies for individualizing child development
services. In addition to serving almost all enrolled families and children in the language they
spoke at home, many programs used the results of developmental assessments to plan future
child development services and activities. Typically, home visitors and center teachers reviewed
the results with parents and worked with them to plan activities appropriate for the child’s stage
of development and to strengthen any areas the assessment identified as weak. Home visitors
often worked with parents to select education topics based on parents’ concerns or interest in
specific developmental areas (such as sleeping, nutrition, toilet training, or motor skills). Within
the framework of a center curriculum or classroom theme, center teachers usually planned
specific activities in response to the needs and interests of their group of children. Many even
planned individualized activities that addressed specific developmental areas for each child.
C. PARENT INVOLVEMENT IN CHILD DEVELOPMENT SERVICES
According to the revised Head Start Program Performance Standards, programs should
involve parents in child development services by involving them in planning child
development activities, helping them improve their child observation skills, and
discussing children’s development with them.
The research programs involved parents in child development services in a variety of ways.
Some programs involved parents directly in conducting developmental assessments, and many
involved parents in reviewing the results and planning services. In families receiving
center-based services, parents participated in parent committees that planned center activities,
and some parents volunteered in center classrooms.
By fall 1999, 15 of the research programs (up from 9 in 1997) had fully implemented
strategies to involve parents in planning and providing child development services. All 15
101
involved at least one parent in most families and some fathers in child development services.
Seven programs had reached an enhanced level of implementation in this area, which entailed
involving at least one parent from almost all families and many fathers in child development
services.
D. GROUP SOCIALIZATIONS
The revised Head Start Program Performance Standards require programs to offer at
least two group socialization activities per month to families who receive home-based
child development services. We rated programs with a home-based option as fully
implemented if they offered these group socialization activities and most families
attended them regularly.
In fall 1999, 3 of the 13 research programs that provided home-based child development
services to some or all families had fully implemented group socializations for those families.
Most programs offered group socializations at least twice a month, but in many programs
participation was low. The apparent drop in the number of programs fully implementing group
socializations (from 11 programs in 1997 to 3 programs in 1999) reflects the addition between
1997 and 1999 of the requirement that most families participate regularly for a rating of “fully
implemented.”3
Programs found it very difficult to achieve high participation rates in group socialization
activities. Some of the challenges related to the logistics of scheduling and conducting group
socializations, and others related to lack of clear direction from the Head Start Bureau about how
group socialization activities should be carried out. Scheduling these activities when most
parents could attend was very difficult. Many parents had busy work schedules and lacked free
time. Other parents had irregular schedules that often conflicted with group socialization
3
The addition of the requirement of regular participation by most families for a rating of
“fully implemented” was based on the researchers’ judgments, not a change in the requirements
in the revised Head Start Program Performance Standards.
102
schedules. Transportation problems also made it difficult for some parents to attend group
socializations, so program staff had to find ways to provide transportation assistance. Some
programs found it challenging to find a good location for these activities, either because of
general program space limitations or because program families lived far from the program
offices.
In addition to logistical challenges, lack of clear direction from the Head Start Bureau and
some programs’ uncertainty about how to carry out the group socialization requirements
probably hampered some programs’ efforts to achieve high participation in these activities
during the initial years of program operations. Some programs were uncertain about how to staff
and organize the socializations, and over time tried several different approaches. For example,
one program tried convening monthly two-hour parent meetings that included parent-child
activities, referring parents to play groups in the community, offering play groups twice a month
at various times, holding annual parent-child events organized around a theme, and planning
small group activities for families in each home visitor’s caseload. In some programs, staff
and/or parents did not have a clear or common understanding of the purpose and intended
content of the group socializations. Sometimes staff did not think that group socializations were
appropriate for infants, because infants were thought to be too young to participate in meaningful
group activities.
In striving to achieve high participation levels in group socialization activities, one program
also had to address issues related to young parents’ experiences in group activities where they
did not feel comfortable or accepted. In addition, staff members in some programs were hesitant
to push families to participate in group socializations when families complained about the
substantial time requirements for participation in other program activities such as home visits.
103
Throughout the evaluation period, programs were trying to meet these challenges and
increase participation in group socializations by:
• Changing the scheduled days and times of group socializations to make them more
accessible to families
• Increasing the number of group socialization opportunities at varying times and days
• Hiring a part-time staff member to plan and organize group activities
• Making group socialization activities more structured, for example, by focusing on a
particular age group or need area, such as pregnancy
E. CHILD CARE
Since the fall 1997 site visits, the Head Start Bureau has clarified its expectation that
programs are to ensure that all child care arrangements used by enrolled families meet
the revised Head Start Program Performance Standards, whether the care is provided
directly by the program or in another community setting. We rated programs as fully
implementing the child care requirements if they helped families who needed it arrange
child care, assessed and monitored the child care arrangements to ensure that they met
the standards, helped families prevent interruptions in child care subsidies, and/or
provided good-quality child care directly.
The proportion of children reported to be in child care arrangements increased slightly over
time (Figure V.4). In six programs, fewer than half of Early Head Start children were in child
care in fall 1999. In 11 programs, more than half of all children were in child care, and in 6 of
these programs (4 of which were center-based), many or all of the children were in child care.
This section of Chapter V focuses on program strategies to arrange for quality care, assess and
monitor arrangements, and ensure continuity. We devote Chapter VIII to describing child care
quality.
104
FIGURE V.4
ESTIMATED PROPORTION OF FAMILIES
USING CHILD CARE
Number of Programs
9
8
7
7
6
6
5
5
4 4 4
4
3
2 2
2
1
0
Less than Half More than Half "Many" All
Fall 1997
Fall 1999
Proportion of Families Using Child Care
SOURCE: Information gathered during visits to the Early Head Start research programs in fall 1997 and fall 1999.
105
In fall 1999, six programs had reached full implementation of the child care requirements,
up from five in fall 1997.4 Five of these programs provided child care directly in Early Head
Start centers to most families who needed it. Another program had established formal
agreements with community child care providers to provide care for Early Head Start children
and work toward meeting the performance standards. This program regularly assessed the
quality of care that community child care partners provided.
Seven programs had reached a moderate level of implementation of the child care
requirements. Some of these programs provided some child care directly to some (but not all)
families who needed it. In addition, some monitored the quality of some community child care
arrangements, but they did not have procedures in place to ensure that all or nearly all child care
used by Early Head Start families met the performance standards.
The research programs adopted a variety of strategies to work towards ensuring that the
child care arrangements in which Early Head Start children received care met the performance
standards (Figure V.5). These strategies included:
• Helping families identify and select high-quality child care arrangements
• Making referrals to specific child care arrangements that they had determined provide
high-quality child care
• Referring families to local resource and referral agencies
• Assessing the quality of care before making placements
4
Between 1997 and 1999, the child care implementation rating scale changed in several
ways. First, we added consideration of the quality of care provided by Early Head Start centers,
with a rating of “full implementation” requiring the provision of good-quality care. For a rating
of “full implementation,” we added two requirements: (1) that if families use child care
subsidies, there must not be interruptions in child care services; and (2) that most children must
be in care that the program assesses and monitors to ensure that it meets the performance
standards.
106
FIGURE V.5
STRATEGIES USED BY EARLY HEAD START RESEARCH PROGRAMS
TO MEET THE PERFORMANCE STANDARDS FOR CHILD CARE
Number of Programs
17
16
15
14
13
12
11 11
11
10
9
8
8 7
7 6 6 6 6
6 5
5 4 4 4
4 3 3 3 3
3
2
1
1
0
Help Make Refer Assess Monitor Visit Train/ Develop Help
Find Referrals to R&R Quality Quality Children Support Formal Obtain
Quality in Care Providers Partner- Subsidiesa
Care ships
Strategies to Ensure Child Care Quality
Fall 1997 Fall 1999
SOURCE: Information gathered during visits to the Early Head Start research programs in fall 1997 and fall 1999.
a
We did not collect information on programs' efforts to help families obtain state child care subsidies in our 1997
site visits. Thus, we report the number of programs implementing this strategy in 1999 only.
107
• Systematically monitoring at least some of the child care arrangements children were
in
• Visiting children in their care settings, where they could observe the care children
were receiving and develop relationships with the child care providers
• Offering training and/or support to child care providers caring for Early Head start
children
• Developing formal partnerships with child care providers that care for Early Head
Start children
• Helping families apply for and obtain state child care subsidy funds
Over time, the number of strategies that programs implemented to work on meeting the
performance standards in community child care settings increased substantially. In 1997, the 17
research programs reported using a total of 29 strategies. By 1999, programs reported using a
total of 62 strategies, or an average of nearly 4 per program.
In the course of implementing strategies to work with community child care partners on
meeting the performance standards, programs faced a number of challenges. Programs had to
start with the care that was available in the community, which in some cases was not sufficient in
supply and generally not of good quality.
Program staff also found that it takes time to work toward meeting the performance
standards in community child care settings, even under the best of circumstances. Community
providers may not be set up to meet the performance standards quickly, even if they are eager to
do so. Moreover, it takes time to build the relationships with community child care providers
that serve as the foundation for solid partnerships through which compliance with the
performance standards can be addressed.
For most child care providers, making the changes necessary to meet the performance
standards required additional resources. For example, resources are required for staff training
and for reducing child-staff ratios and group sizes. Many programs initially did not have the
108
resources needed to pay for such changes. Some programs obtained additional funds from a
variety of sources (such as expansion and quality improvement grants from ACYF and state
Early Head Start grants) to support child care quality, but obtaining these resources took time.
In the past several years, new state child care initiatives and increases in state child care
subsidy funds have made it easier for families to obtain financial assistance to pay for child care.
In fall 1999, 11 programs helped families apply for and obtain state subsidy funds, which also
helped to increase resources available to pay for good-quality care. Six helped families obtain
subsidies to pay for child care in community settings, three helped obtain subsidies for center-
based care provided directly by the program, and two helped obtain subsidies for extended-hours
care. Four programs used child care subsidy funds to cover a portion of the cost of their Early
Head Start centers.
Despite the availability of subsidies, some families still had difficulty paying for child care.
In fall 1999, 10 research programs were implementing strategies to prevent interruptions in child
care and help parents pay for good-quality child care. Four programs used subsidies to pay for
Early Head Start center care but covered the full cost of care with program funds when families
experienced interruptions in subsidies. Three programs set aside program funds to help families
make co-payments, pay the difference between the provider’s rate and the subsidy rate, and/or
pay for child care during gaps in subsidy coverage. Other strategies included funding
community child care slots as a last resort for families who could not obtain subsidies, providing
extended-hours slots for families who could not obtain subsidies, and using a state grant to pay
for community child care.
Another challenge the programs sometimes faced was ensuring good quality in the child
care settings that parents selected. Parents sometimes chose care without input from program
staff, either because they had to find care quickly when they found a job or because they
109
preferred a familiar arrangement with an informal provider whom they knew and trusted. These
informal providers are not always interested in or even willing to work with program staff to
assess or improve the quality of care they provide.
F. HEALTH SERVICES FOR CHILDREN
The revised Head Start Program Performance Standards charge programs with
ensuring that all children have a regular source of health care and access to the health,
dental, and mental health services they need. Programs must also track health services
to ensure that children receive all recommended well-child examinations,
immunizations, and needed treatments.
By fall 1999, the number of research programs that had fully implemented the health
services requirements nearly doubled, from 7 programs in fall 1997 to 13 in fall 1999. Six had
reached an enhanced level of implementation—they systematically tracked receipt of well-child
examinations, immunizations, and treatment, and children received health services without delay.
In fall 1999, four programs were rated as reaching only a moderate level of implementation of
child health services. One of the four did not provide adequate access to mental health services.
In three of the four, less than 90 percent of children were up-to-date on immunizations and
well-child examinations, which indicates that adequate tracking systems were not in place or that
program staff had not been able to work effectively with all parents to ensure that they obtained
the health services their children needed. In one of these programs, problems with the
management information system made it difficult to discern whether immunization rates were
low or record-keeping was incomplete.
The research programs took a variety of approaches to ensuring that children received
needed health services:
• All programs helped families find regular sources of medical care (“medical homes”)
for their children, and some helped families navigate their state’s Medicaid managed
care system.
110
• Several programs provided mental health services through agency staff and
community partners to families who needed it. Some programs provided child mental
health services on site at their centers.
• Several programs had nurses on staff who provided some health services (especially
well-child examinations), tracked receipt of health services, and helped families
arrange for services.
• One program held special health screening days at its centers and recruited area
physicians, dentists, and other specialists to conduct the screenings.
• Programs often used the HSFIS and other software packages to track receipt of health
care services.
• Several programs provided transportation to medical appointments when families
needed it.
G. FREQUENCY OF CHILD DEVELOPMENT SERVICES
The performance standards require programs to provide one home visit per week (48 to
52 visits per year) to families receiving home-based services. For center-based services,
the performance standards require programs to offer classes at least four days per week,
for between 3.5 and 6 hours per day. We rated programs as fully implemented on this
dimension if almost all children received child development services at least three times
per month (through three completed home or center visits or regular attendance at a
center) and parent education at least monthly.5
The number of programs that had reached full implementation of child development services
at this frequency increased slightly, from 8 in fall 1997 to 10 in fall 1999. Although they were
closer in fall 1999 than in fall 1997 to meeting the requirements for completing planned home
visits with home-based families, the research programs continued to struggle with meeting these
requirements throughout this period. In fall 1999, 8 out 13 programs providing home-based
5
This rating was designed to help us assess whether most children and families were
receiving services of sufficient intensity to have an impact on child development. The frequency
of child development services required for a rating of “fully implemented” was raised from two
completed home visits per month in the 1997 rating scale to at least three completed home visits
per month in the 1999 rating scale to reflect the Head Start Bureau’s increased emphasis on
completing the number of visits required in the performance standards. For the evaluation’s
purposes, we set the requirement for being “fully implemented” lower than the four per month of
the performance standards based on input from consultants suggesting that three per month is
more realistic.
111
services reported that home-based families received an average of 3 home visits per month,
whereas in fall 1997, the majority reported completing an average of 1 or 2 per month. Only one
program reported completing the required four per month in fall 1999, on average. Four
programs reported completing an average of two per month (Figure V.6).
The research programs worked hard to increase the frequency of completed home visits.
Their efforts included:
• Conducting home visits during evenings and on weekends to accommodate parents’
schedules (although some programs found that evening visits are difficult because
parents are tired and children want to be with their parents exclusively, and that
Saturdays are difficult because parents are often busy with chores and errands)
• Conducting some home visits with children (and sometimes parents) in their child
care settings
• Persistently and consistently scheduling home visits and inviting families to program
activities
• Requiring families to meet with home visitors, and terminating families who do not
start meeting with their home visitor within a certain period
• Reconfiguring service options so that families in the home-based option were
receiving the most appropriate services for their needs
• Building children’s enthusiasm for home visit activities and causing them to look
forward to visits (children can be powerful agents in engaging parents in home visits)
Along with the frequency of completed home visits, the amount of time typically spent on
child development during these visits also determines the intensity of child development services
delivered to families receiving home-based Early Head Start services. A focus on child
development means that home visitors spent time in activities with the child alone or with the
child and parent together, or on parenting education with the parent. Nearly all programs
reported that home visitors spent more than half the typical visit on child development (Figure
V.7). In the accompanying box, Carla Peterson, a research partner with the Marshalltown, Iowa,
program, gives an in-depth analysis of how home visitors spent their time during home visits.
112
Looking Closer: Interactions During Home Visits
Carla Peterson
Iowa State University
The Mid-Iowa Community Action, Inc. (MICA) Early Head Start program uses home visits as its primary mode of service delivery.
All families work with two professional staff members: a family development specialist (FDS) and a child development specialist (CDS),
whose roles are largely described by their titles. MICA’s theory of change, as well as its programmatic resources, are focused on facilitating
child development through strengthening parents’ skills for their roles and supporting them in their parenting roles. The families being
served in central Iowa are primarily Caucasian, with a few Hispanic families and even fewer of other ethnicities. Most live in small towns or
rural areas, and approximately half are single-parent families.
Data to describe the process and content of home visits were collected using the Home Visit Observation Form (HVOF). The HVOF
enables the observer to record information simultaneously on three major aspects of the home visit process: (1) interaction partners (parent
and child; interventionist and parent; joint interaction with the parent, child, and interventionist; interventionist with another adult; parent
with another adult), (2) content of interaction (child’s development, parenting issues, family relationship issues, community
resources/referral, parent education/employment), and (3) nature of the interventionist’s interaction (working directly with the child,
modeling for the parent, facilitating parent-child interaction, observing an interaction, asking for and/or providing information).
Within each category, data were collapsed across observed visits, and the percentages of overall time spent in each of the various
interaction and activity arrangements was calculated. When the CDSs interact with the child, it is generally within the context of joint
interactions with the parent and child. However, the parent spends little time interacting directly with the child. The CDSs spend about one-
third to half of their time interacting with adults. The interventionists spend time on content areas that are consistent with their roles.
70%
60%
50%
40%
30%
20%
10%
0%
A d u lts w ith C h ild J o in t A d u lt C D S /F D S P a re n t O th e r
C D S N =500 FD S N =519
70%
60%
50%
40%
30%
20%
10%
0%
C h ild F o c u s F a m i ly F o c u s A d m i n /O th e r
CD S N =500 FD S N =519
Both CDSs and FDSs spend most of their time supporting adult communications, largely in providing and asking for information.
The content of the communication varies with the person’s role, but both FDSs and CDSs spend large amounts of time involved in
discussions with parents.
80%
70%
60%
50%
40%
30%
20%
10%
0%
S u p p o r t C h il d - O r i e n te d C o m m u n ic a ti o n S u p p o r t A d u l t C o m m u n i c a t io n O th e r
CDS N =500 FD S N =519
113
FIGURE V.6
FREQUENCY OF COMPLETED HOME VISITS IN EARLY HEAD START
RESEARCH PROGRAMS FOR FAMILIES RECEIVING HOME-BASED SERVICES
Number of Programs
13
12
11
10
9
8
8
7
6
6
5
4
4
3
3
2
2
1
1 1
1
0 0
0
One Two Three Four Don't Know
Fall 1997
Fall 1999
Average Number of Home Visits per Month for Families that Received
Home-Based Services
SOURCE: Information gathered during visits to the Early Head Start research programs in fall 1997 and
fall 1999.
114
FIGURE V.7
PERCENTAGE OF TIME TYPICALLY SPENT ON CHILD DEVELOPMENT
IN HOME VISITS
Number of Programs
10
9
9
8
7
6
5
4 4 4
4
3
2
2
1 1 1
1
0
Under 50% 50-74% 75-100% Varies
Fall 1997
Fall 1999
Percentage of Home Visit Time Typically Spent on Child
Development
SOURCE: Information gathered during visits to the Early Head Start research programs in fall 1997 and
fall 1999.
115
Besides home visits, programs provided parenting education in a variety of settings,
including group sessions for parents, group socialization activities, individual meetings or
counseling sessions, and daily contacts with parents at Early Head Start centers, as well as
through newsletters, resource libraries, and journal writing (Figure V.8).
H. SERVICES FOR CHILDREN WITH DISABILITIES
The revised Head Start Program Performance Standards require programs to refer
families to Part C when they suspect a child has a disability. Staff must also work
closely with the Part C provider to coordinate services, and the performance standards
encourage them to develop joint service plans whenever appropriate. At least 10
percent of enrolled families must have a child with an identified disability. We rated
programs as fully implemented in this area if (1) they referred families to Part C
providers and followed up with families promptly, (2) they worked closely with Part C
staff to coordinate services, and (3) at least 10 percent of enrolled families had a child
with an identified disability (or the program made vigorous efforts to recruit children
with disabilities).6,7
By fall 1999, 12 of the 17 research programs had fully implemented services for children
with disabilities (Figure V.3). Strategies for coordinating with Part C included:
• Developing joint service plans
• Arranging therapy services to be provided in Early Head Start classrooms
• Arranging for Early Head Start staff to serve as the service coordinator for Individual
Family Service Plans (IFSPs)
• Participating with parents and Part C providers in service coordination meetings
6
This rating was included together with the rating of developmental assessments in the 1997
rating scales. Therefore, there was no separate rating of this aspect of child development
services in 1997.
7
Part C providers are agencies designated under Part C of the Individual with Disabilities
Education Act (IDEA) Amendments of 1997 (PL 105-17) to be responsible for ensuring that
services are provided to all children with disabilities between birth and age 2.
116
FIGURE V.8
STRATEGIES BEYOND HOME VISITING USED BY EARLY HEAD START
RESEARCH PROGRAMS TO PROVIDE PARENTING EDUCATION
Number of Programs
17
16
15
14
14
13
13
12
11
10
9
8
7
7
6
5 5
5
4
4
3
3
2
2
1 1
1
0
Paren Group Individual Dail Other
Group Socializations Meetings Contacts
Meeting
Parenting Education Strategies Beyond Home Visits
Fall 1997
Fall 1999
SOURCE: Information gathered during visits to the Early Head Start research programs in fall 1997 and
fall 1999.
117
• Forming Special Quest teams with local Part C providers to work on enhancing
coordination between the two programs 8
I. SUMMARY
Between fall 1997 and fall 1999, the research programs made substantial progress in
implementing the key aspects of the revised Head Start Program Performance Standards that we
examined. Although implementing several aspects of child development services continued to
present challenges to many of the programs (especially achieving good attendance at group
socializations and ensuring good-quality child care for families receiving home-based services),
most programs achieved a rating of “full implementation” for other aspects of child development
services. The pathways that programs took as they progressed toward full implementation are
examined in Chapter X.
8
Special Quest joined the Head Start training and technical assistance system this year as the
Hilton/Early Head Start Training Program. This program, a public/private partnership between
the Conrad N. Hilton Foundation and the Head Start Bureau, is administered by the California
Institute on Human Services at Sonoma State University. Its mission is to help professionals and
family members involved in Early Head Start and Migrant Head Start programs develop skills
and strategies for working with infants and toddlers who have significant disabilities.
118
VI. PROGRESS IN IMPLEMENTING FAMILY AND
COMMUNITY PARTNERSHIPS
Ongoing family and community partnerships are critical for supporting Early Head Start and
Head Start programs in their efforts to promote children’s healthy development. The Head Start
program is “family centered and is designed to foster the parent’s role as the principal influence
on the child’s development and as the child’s primary educator, nurturer, and advocate”
(Department of Health and Human Services 1996, p. 57186). Similarly, the revised Head Start
Program Performance Standards emphasize that Early Head Start and Head Start programs are
intended to be “community-based, with different specific models of service delivery flowing out
of the differing needs of differing communities.” The performance standards envision programs
as “central community institutions for low-income families, building linkages and partnerships
with other service providers and leaders in the community” (Department of Health and Human
Services 1996, p. 15187). Thus, central questions for the implementation study were: Were
Early Head Start programs implementing family and community partnerships by their third year
of delivering services?, Were aspects of these activities especially challenging?, and Did
programs experience particular successes in these areas?
In the area of family partnerships, the performance standards address program practices in
several domains:
• Setting goals for families
• Gaining access to community services and resources
• Providing services to pregnant women who are enrolled in Early Head Start
• Encouraging parent involvement in the program
119
• Providing child development and education; health, nutrition, and mental health
education; transition activities; and home visits
• Advocating in the community
To be rated as fully implementing family partnerships, programs had to be rated as fully
implementing services in most dimensions that we rated, including frequency of family
development services, development of individualized family partnership agreements (IFPAs),
availability of services, and parent involvement.1
The performance standards address the following aspects of community partnerships:
• Partnerships
• Advisory committees
• Transition services
To be rated as fully implementing EHS community partnerships, programs had to be rated as
fully implementing services in most of the dimensions that we rated, including collaborative
relationships, advisory committees, and transition planning.
A. FAMILY PARTNERSHIPS: CHANGES IN SERVICES AND IMPLEMENTATION
PROGRESS BETWEEN 1997 AND 1999
The research programs made significant strides in implementing Early Head Start’s family
partnerships, and by fall 1999, three years after they began serving families, two-thirds had
1.
1
In Chapter IV we reported ratings of parent involvement in child development activities,
which refers to their involvement in the planning and delivery of such services. In this chapter,
parent involvement refers to parents’ participation in program policymaking, operations, and
governance. These activities may include child development and other components of the Early
Head Start Program.
120
reached full implementation in this area. The number that achieved full implementation
increased from 9 to 12 between fall 1997 and fall 1999 (Figure VI.1).
1. Individualized Family Partnership Agreements
The revised Head Start Program Performance Standards require that programs develop
IFPAs in collaboration with families, review them regularly, and update them as needed.
Fourteen research programs had fully implemented these requirements in fall 1999 (Figure
VI.2), up from 8 in fall 1997. Nine were rated as having reached an enhanced level of
implementation in this area in fall 1999 because they had learned about the other services that
families received, coordinated with other service providers, and conducted joint planning when
appropriate. The programs that had reached only moderate implementation of the IFPA
requirements in fall 1999 had developed IFPAs with fewer than 90 percent of the families in
their caseloads.
2. Availability of Services
The revised Head Start Program Performance Standards require programs to make a
wide range of services available to families, either by providing them directly or through
referral to other community service providers, and to follow up systematically to ensure
that families receive the services they need.
Between fall 1997 and fall 1999, the number of programs that were fully implementing these
requirements nearly doubled, from 6 to 11 (Figure VI.2). Eight had reached an enhanced level of
implementation of the service availability requirements by fall 1999 because, in addition to
following up on services families received, they assessed and monitored the quality of family
development services offered. The programs that were rated as moderately implemented did not
systematically follow up on referrals.
121
FIGURE VI.1
EARLY HEAD START FAMILY PARTNERSHIPS
IMPLEMENTATION RATINGS
Number
of Programs
17
Partial Implementation Full Implementation
16
15
14
13
12
11
10 9 9
9
8
7 6
122
6 5
5
4 3
3 2
2
1 0 0 0 0
0
1 2 3 4 5
Minimal Low-Level Moderate Full Enhanced
Implementation Implementation Implementation Implementation Implementation
Ratings
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 17 Early Head Start research programs.
Note: Implementation ratings for family partnerships represent the average rating across all the dimensions we examined.
Programs rated as fully implemented achieved full implementation in most of the dimensions we examined, but did not
necessarily achieve full implementation in every dimension.
FIGURE VI.2
EARLY HEAD START FAMILY PARTNERSHIPS
ASPECTS THAT WERE FULLY IMPLEMENTED
Number of Programs
That Reached Full
Implementation
17 16
16 15
15 14
14
13
12 11
11
10
123
9 8 8
8
7 6
6 5 Included in
5 4 Parent
4 Involvement
3 Rating
2 in 1999
1
IFPAs Availability Frequency of Parent Father
of Services Services Involvement Initiatives
Aspects of Family Development Services
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 17 Early Head Start research programs.
IFPA = Individual Family Partnership Agreement.
3. Frequency of Services
Although the performance standards do not specifically address frequency of family
development services, we rated programs as fully implemented with respect to the
frequency of family development services if most families regularly received such
services.
As in other areas, the number of programs that were fully implemented nearly doubled, from
8 to 15 (Figure VI.2). The fully implemented programs held regular case management meetings
(at least monthly) with families, either during home visits or in conferences at program centers,
parents’ workplaces, or parents’ school sites. In addition, many programs provided some
services—such as health, employment, or counseling services—directly and also made referrals
to community providers. Two programs were rated as moderately implemented on this
dimension because some families did not have case management meetings at least monthly with
program staff.
4. Parent Involvement
The revised Head Start Program Performance Standards require programs to involve
parents in child development services (this type of parent involvement is discussed in
Chapter V, Section B.3), to involve them in policymaking and program operations, and
to give them multiple opportunities to participate as volunteers or employees (this type
of parent involvement is rated under family partnerships). In addition to the
requirements for parent involvement in the performance standards, the Head Start
Bureau clarified its expectation that programs try to increase father involvement. We
rated programs as fully implemented in this area if the program provides multiple
opportunities for involvement in policy groups and volunteer activities (with most
parents involved in some capacity) and makes special efforts to encourage father
involvement (with some fathers participating).2
1.
2
In 1997, we rated parent involvement and father initiatives separately, with the rating of
father initiatives indicating simply whether or not the program made any special effort to involve
fathers. Nearly all the programs had a special father initiative in 1997. In 1999, we made the
rating criteria more rigorous to assess whether programs had established comprehensive
approaches to involving both mothers and fathers and were succeeding in involving them.
124
In fall 1999, four programs had fully implemented these parent involvement requirements,
down from five in fall 1997 (Figure VI.2). In part because of welfare reform, many parents were
working and finding it more difficult to make time for volunteering and participating in other
program activities. Six programs achieved moderate implementation of the parent involvement
requirements. These programs involved many parents, including some fathers, in policy groups
and volunteer activities.
The research programs promoted parent involvement in a variety of ways (Figure VI.3). All
programs had Policy Councils that involved varying numbers of parents in program decision
making in areas such as policies and procedures, staff roles and responsibilities, staff
employment-related decisions, budgets, and curricula. By fall 1999, in addition to Policy
Councils, most programs had Parent Committees to involve more parents in program planning
and activities. In programs with centers, these were formed separately for parents at each center.
In rural areas, Parent Committees were often formed based on geographical location. In some
programs, the Policy Council established committees to address specific topics or oversee
particular areas, such as personnel, finance/budgets, funding, field trips, center activities,
fundraising, and grievances.
Most programs also offered opportunities for parents to volunteer, such as by assisting in
classrooms, doing office work, making repairs, organizing fundraising or social activities,
contributing to newsletters, helping to plan meetings, providing peer support, and serving as bus
monitors.
All programs encouraged fathers and father figures to participate in regular services and
activities. In fact, the majority of programs (16 in 1997 and 13 in 1999) made special efforts to
involve fathers and father figures in program activities. Four programs had a designated staff
position, usually a coordinator or specialist, assigned responsibility for involving fathers in
125
FIGURE VI.3
ACTIVITIES TO PROMOTE PARENT INVOLVEMENT
17
Policy Council
17
9
Parent Committees
15
14
Volunteer Opportunities
15
10
Special Activites for Fathers Only
9
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Number of Programs
Fall 1997 Fall 1999
SOURCE: Information gathered during visits to the Early Head Start research programs in the fall of 1997
and fall of 1999.
126
program activities; two additional programs had male staff members with other responsibilities
who promoted efforts to involve fathers. Six programs offered group activities for men or for
men and their children. These groups usually met monthly. Five additional programs organized
recreational activities for men only. In addition, many programs had special activities designed
for fathers only (Figure VI.3). These included such activities as father support groups, father-
only nights out, father sports teams and events, and “daddy-and-me” volunteer days at the child
development center.
Although many programs experienced growth in father involvement, a few were not making
special efforts to involve fathers in fall 1999. In a few cases, programs eliminated staff positions
for father involvement due to low participation by the fathers. Other programs faced several
obstacles in their efforts to involve fathers. Some fathers were uncomfortable being the only
male present at program activities, or they perceived that activities were for mothers, not fathers.
Some programs had no (or not enough) male staff, and fathers were sometimes reluctant to
attend events led by female staff. In addition, some mothers did not want nonresident fathers to
be involved with their children or the program. Resident fathers sometimes were not at home
when home visits were scheduled, or visits could not be scheduled when fathers were at home.
When staff with responsibility for involving fathers left the program, they could not always be
replaced quickly. Finally, in some programs other issues simply took priority. Some programs
recognized the importance of special efforts to involve fathers but focused on other aspects of
program services that that they believed were more pressing at the time.
B. COMMUNITY PARTNERSHIPS: CHANGES IN SERVICES AND
IMPLEMENTATION PROGRESS BETWEEN 1997 AND 1999
The research programs improved their implementation of community partnerships
dramatically over the evaluation period. The number that had fully implemented their
127
community partnerships component nearly doubled between fall 1997 and fall 1999, from 8 to
15 (Figure VI.4).
1. Collaborative Relationships
The revised Head Start Program Performance Standards require programs to establish
collaborative relationships with other community service providers, with the goal of
increasing access to services that are responsive to the needs of children and families.
The number of research programs that had fully implemented collaborative relationships
increased from 11 to 16 between fall 1997 and fall 1999 (Figure VI.5). The fully implemented
programs had established many relationships with other service providers, including some formal
written agreements. These included partnership with Part C agencies and with child care
providers (see Chapter V). They also communicated regularly with service providers to
coordinate services for families and participated in at least one coordinating group of community
service providers. One program received a lower implementation rating in the area of
collaborative relationships because it had established few relationships with other service
providers (it provided center-based child care, and the grantee offered many other services in
house).
2. Advisory Committees
According to the revised Head Start Program Performance Standards, programs must
establish a health advisory committee that involves community health services providers
and meets regularly to discuss infant and toddler health.
The number of programs that had fully implemented these requirements nearly doubled
between fall 1997 and fall 1999, from 7 to 13 (Figure VI.5). Five were rated as having reached
an enhanced level of implementation in this area because they had established at least one
additional advisory committee to advise them on infant and toddler matters. Several programs
128
FIGURE VI.4
EARLY HEAD START COMMUNITY PARTNERSHIPS
IMPLEMENTATION RATINGS
Number
of Programs
10
Partial Implementation Full Implementation
9
8 8 8
8
7
7
6
5
129
4
3
2
2
1
1
0 0 0 0
0
1 2 3 4 5
Minimal Low-Level Moderate Full Enhanced
Implementation Implementation Implementation Implementation Implementation
Ratings
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 17 Early Head Start research programs.
Note: Implementation ratings for community partnerships represent the average rating across all the dimensions we examined.
Programs rated as fully implemented achieved full implementation in most of the dimensions we examined, but did not
necessarily achieve full implementation in every dimension.
FIGURE VI.5
EARLY HEAD START COMMUNITY PARTNERSHIPS
ASPECTS THAT WERE FULLY IMPLEMENTED
Number of Programs
That Reached Full
Implementation
17 16
16
15
14 13
13
12 11
11 10
10
130
9
8 7
7
6
5
4
4
3
2
1
Collaborative Advisory Transition
Relationships Committees Plans
Aspects of Community-Building Activities
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 17 Early Head Start research programs.
had not reached full implementation of advisory committees by fall 1999. At one program, the
health advisory committee had been established shortly before the fall 1999 site visit and was not
yet meeting regularly. The health advisory committees at three other programs advised the
agencies on broader health issues but did not discuss infant and toddler health on a regular basis.
3. Transition Planning
To ensure a smooth transition from Early Head Start to Head Start or another preschool
program, the revised Head Start Program Performance Standards require programs to
develop individualized transition plans in collaboration with parents for all children at
least six months before their third birthday.
The number of research programs that had fully implemented these transition-planning
requirements more than doubled between fall 1997 and fall 1999, from 4 to 10 (Figure VI.5). Of
these, 7 had reached an enhanced level of implementation: all children in these programs had
transition plans in place by age 2½, and parents were active participants in the transition
planning. Seven programs were rated as moderately implemented in this area in fall 1999, either
because not all children had a transition plan in place by age 2½ or because the program had not
identified alternatives for families who could not enroll or did not wish to enroll their child in
Head Start.
It appears that many Early Head Start children enrolled in Head Start. Information on where
children who had transitioned out of Early Head Start went was not available for all programs,
but slightly more than half the research programs reported that at least half the children who
remained in the program until they were transitioned out went to Head Start.
C. SUMMARY
As in the case of child development and health services, the research programs made
substantial progress in implementing the elements of family and community partnerships that we
131
examined. Although involving parents—both mothers and fathers—continued to challenge the
programs, most had fully implemented the other aspects of family partnerships. The programs
also made substantial progress in implementing community partnerships, and by fall 1999, nearly
all had reached full implementation. These partnerships played a key role in programs’ progress
toward full implementation of child development services, as will be seen in Chapter X.
132
VII. P
ROGRAM IMPLEMENTATION: STAFF DEVELOPMENT AND
PROGRAM MANAGEMENT
Qualified, committed staff members are the backbone of any service program. In the case of
Early Head Start, the revised Head Start Program Performance Standards emphasize the
importance of well-qualified staff and effective program management for achieving the overall
goal of improving the social competence of children in low-income families. The performance
standards and the Early Head Start Program Grant Availability Notice both stress the key role of
staff supervision, training, and support, and the grant announcement directs programs to select
staff and design staff development approaches with the knowledge that high-quality staff
performance is linked to rewards such as salary, compensation, and career advancement. The
performance standards also lay out requirements for program management and governance to
ensure that programs operate effectively to accomplish their goals.
In human resources management, the performance standards include requirements in the
areas of organizational structure, staff qualifications, staffing patterns, staff performance
appraisals, staff training and development, and staff health. We focused the implementation
ratings on supervision (including performance appraisals) and staff training and development;
however, we examined descriptive data in the other areas. To be rated as “fully implemented” in
staff development, programs had to be fully implementing the performance standards in most of
the dimensions of staff development that we rated, including supervision, training,
compensation, morale, and staff retention.1
1
Staff morale is not specifically addressed in the performance standards, but we included it
in our ratings because it is an important indicator of the supportiveness of the work environment.
133
The revised Head Start Program Performance Standards also address a number of aspects of
program management, including:
• Program governance, including Policy Councils and Parent Committees
• Management systems and procedures, including program planning, communications,
and program self-assessments and monitoring
To be rated as fully implementing Early Head Start management systems, programs had to
be fully implementing the performance standards in most dimensions of management systems
that we rated, including functioning of the Policy Council; community needs assessment;
communication systems; goals, objectives, and plans; and self-assessment.
In this chapter we describe the implementation of staff development and management, and
review progress and changes that programs experienced between fall 1997 and fall 1999.2
Information for this review comes from both the implementation study site visit interviews and
the self-administered survey that most Early Head Start staff responded to at the time of the 1997
and 1999 visits. We begin with the areas in which information is exclusively from site visits
(supervision and staff retention). We then discuss areas, such as staff training and education, in
which we have data from both sources, and conclude with the areas examined only through the
staff survey. First, however, we describe the characteristics of the staff who were responsible for
carrying out the Early Head Start mission in the 17 Early Head Start research programs.
2
The 1997 staff information can be found in the earlier implementation report, Leading the
Way: Characteristics and Early Experiences of Selected Early Head Start Programs, Volume I:
Cross-Site Perspectives, Chapter III (Administration on Children, Youth and Families 1999a).
134
A. EARLY HEAD START STAFF CHARACTERISTICS
Early Head Start staff members are diverse in many ways, but they also share a number of
characteristics (Table VII.1). Overall, their characteristics changed little between 1997 and
1999. In 1999, three-fourths of all staff members (76 percent) had children of their own, and
about a third had children who participated in Early Head Start or Head Start; 61 percent were
currently married. Although the vast majority were women (94 percent in 1999, with the staff at
five programs being entirely female), they were ethnically diverse. Overall, 53 percent of Early
Head Start staff members were white, 28 percent were African American, and 14 percent
identified themselves as of Hispanic origin, the remaining being Asian or other ethnicity.
The racial/ethnic composition of program staff generally reflected that of the families their
program served. Although the percentage of staff in each racial/ethnic group within a site rarely
matched the percentage of families, the distributions were similar in most programs.
Considering the three major racial/ethnic groups among Early Head Start families—white,
African American, and Hispanic—in 10 of the programs, the ranking of these groups by their
percentage was the same for staff and families (for example, if the most families were Hispanic,
the second-most white, and the fewest African American, then the highest proportion of staff was
Hispanic, followed by white and African American). Whenever programs had at least 10 percent
of their families in a particular racial/ethnic group, they also had at least one staff member who
identified themselves as members of that group.
It is also important for staff to be able to communicate with their families, and in general,
the percentage of staff who reported speaking Spanish paralleled the percentage of families in the
programs whose primary language was not English. Across all 17 programs, about 20 percent of
parents reported that their primary language was not English, and this ranged from 0 to 81
percent across the programs. Overall, about one-quarter (23 percent) of staff spoke Spanish, and
135
TABLE VII.1
PERCENTAGE OF EARLY HEAD START STAFF WITH PARTICULAR CHARACTERISTICS FOR THE
FULL SAMPLE AND BY PROGRAM APPROACH IN 1997
Program Approach in 1997
Range of
Full Percentage Center- Home- Mixed
Sample Across Programs Based Based Approach
Had Children of Their Own 76 45–100 82 72 73
Had Children Who Participated in
Head Start or Early Head Start 35 0–71 52 24 25
Currently Married 61 25–88 62 63 59
Women 94 60–100 98 88 97
White 53 22–100 46 62 51
African American 28 0–78 28 19 37
Hispanic Origin 14 0–72 21 15 5
At Some Time Lived in
Neighborhood Served by Program 46 27–68 43 53 42
Member of Religious, School,
Political, or Social Group in
Community Program Served 33 9–68 23 43 34
SOURCE: Survey of program staff conducted in fall 1999.
136
another 5 percent spoke another language (other than English). At the site level, the percentage
of staff who spoke Spanish ranged from 0 (at two programs) to 91 percent (at the program that
served predominantly migrant families).
Early Head Start staff members had ties to the communities they served, which provided a
basis for their being able to understand the needs and circumstances of the families they served.
Almost half of Early Head Start staff members (46 percent) reported that at some time in their
life they had lived in a neighborhood served by the program. Almost four-fifths of these were
living in their program’s neighborhood at the time of the survey, and one-fifth reported that they
grew up in that neighborhood. One-third of Early Head Start staff were currently members of a
religious, school, political, or social group within the community their program served. Some
differences occurred by program approach. Staffs in home-based programs were more likely to
have membership in such a group (43 percent, compared with 34 percent for mixed-approach
and 23 percent for center-based program staff). Home-based program staff members were also
more likely to have ever lived in their program’s neighborhood (53 percent, compared with just
over 40 percent for staff in center- and home-based programs).
B. STAFF DEVELOPMENT PRACTICES AND IMPLEMENTATION IN 1999
AND PROGRESS BETWEEN 1997 AND 19993
As a group, the Early Head Start research programs strengthened their implementation of
staff development during the evaluation period, and by fall 1999, nearly all the programs had
fully implemented the staff development areas that we examined. In fall 1999, 15 research
3
The data on staff development issues are both qualitative (from the site visits) and
quantitative (from a staff self-administered survey completed at the time of the site visits in 1997
[by 356 research program staff members] and 1999 [by 416 research program staff members]).
The two staff surveys provide cross-sectional data at the two points in time; they do not permit
longitudinal analysis of the same staff over time.
137
programs had fully implemented the Head Start staff development requirements (that is, had
achieved a status of full or enhanced implementation), compared with 11 programs in fall 1997
(Figure VII.1). No research programs remained at a low level of implementation in fall 1999,
whereas three programs had been at that level in 1997.
1. Supervision
The revised Head Start Program Performance Standards and the Early Head Start grant
announcement mandate that programs implement a system of supervision, training, and
mentoring that emphasizes relationship building, employs experiential learning
techniques, and provides regular opportunities for feedback on performance.
By fall 1999, all the research programs had fully implemented these requirements, up from
12 programs in fall 1997 (Figure VII.2). Ten programs had reached an enhanced level of
implementation of these requirements by fall 1999—they provided both individual and group
supervision sessions, as well as feedback on performance that was based in part on observation
of service delivery (in centers or during home visits).
2. Staff Retention
The revised Head Start Program Performance Standards and the Early Head Start grant
announcement emphasize the importance of developing and maintaining secure,
continuous relationships between staff, children, and parents and avoiding frequent
turnover of key people in children’s lives. We rated programs as fully implemented in
the area of staff retention if less than 20 percent of the staff had left the program and
been replaced in the previous year.4
In fall 1999, 8 research programs were rated as fully implemented in the area of staff
retention, down from 10 programs in fall 1997 (Figure VII.2). Although the number of programs
that met the requirement for a rating of “fully implemented” in the area of staff retention
4
We chose 20 percent as the benchmark for full implementation because it is low relative to
the average staff turnover rates in child care centers, yet it allows for some turnover for reasons
outside the program’s control and for some turnover that can be healthy for a program.
138
FIGURE VII.1
EARLY HEAD START STAFF DEVELOPMENT ACTIVITIES
IMPLEMENTATION RATINGS
Number
of Programs
14
14
Partial Implementation Full Implementation
13
12
11
10
9
8
8
7
6
139
5
4
3 3 3
3
2
2
1
1
0 0 0
0
1 2 3 4 5
Minimal Low-Level Moderate Full Enhanced
Implementation Implementation Implementation Implementation Implementation
Ratings
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 17 Early Head Start research programs.
Note: Implementation ratings for staff development represent the average rating across all the dimensions we examined.
Programs rated as fully implemented achieved full implementation in most of the dimensions we examined, but did not
necessarily achieve full implementation in every dimension.
FIGURE VII.2
EXTENT TO WHICH FIVE EARLY HEAD START STAFF DEVELOPMENT ACTIVITIES
WERE FULLY IMPLEMENTED
Number of Programs
that Reached Full
Implementation
17
17
16 15
15
14
13 12 12
12
11 10 10
140
10 9
9 8 8 8
8
7
6
5
4
3
2
1
Supervision Training Staff Retention Compensation Morale
Aspects of Staff Development Activities
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 17 Early Head Start research programs.
declined slightly over time, the number experiencing very high rates of staff turnover decreased
between fall 1997 and fall 1999. In fall 1997, three programs had experienced staff turnover
rates of 40 percent or more in the previous year, while in fall 1999, no programs had experienced
staff turnover rates that high in the past year.
Unfortunately, high turnover rates are common among early childhood programs. Among
all staff, turnover in the majority of Early Head Start research programs was in the 15 to 32
percent range in fall 1999. Among Early Head Start direct care staff across the 11 programs that
offered all or some center-based care, turnover averaged 39 percent, and ranged from 6 percent
to 66 percent across the programs. These levels of turnover are comparable to estimates of
turnover rates for frontline staff in child care centers nationally, which range from 25 percent
(Kisker et al. 1991) to 43 percent (Cost, Quality, and Child Outcomes Study Team 1995).
Programs reported a number of reasons for staff turnover, including:
• Personal reasons, such as health problems, family moves, or decisions to stop
working and stay home with children
• Career reasons, such as returning to school, moving for job advancement, or finding a
higher-paying job (often with the public schools)
• Performance reasons, such as dismissal for poor performance
• Programmatic reasons, such as program reorganization, changing program skill needs
Program staff sometimes viewed staff turnover positively, because it sometimes created openings
that allowed program managers to hire staff members who were better suited to the position.
Some staff members who left the Early Head Start programs took similar jobs with other
agencies in the community. Program managers often reported that the training and experience
that those staff members had received during their tenure with the Early Head Start program
continued to benefit the program through new or improved working relationships among
141
agencies. Similarly, some program managers noted that the training and experience provided to
the staff members who left Early Head Start continued to benefit the community by increasing
the qualifications and competence of staff members in social service agencies more generally.
Many of the research programs maintained continuity in program leadership staff, but
slightly more than half of them (nine programs) experienced turnover of directors during the
evaluation period. In three of these instances, however, the change was developmental, as
directors moved to higher positions within their agencies and another Early Head Start staff
member assumed the role of director. The experience of the other six sites showed the variety of
processes involved in leadership transitions. For example, in one case, the position was vacant
for nine months while the program searched for a new director, and then administrative details
initially occupied a large share of the new director’s time. In another program, turnover was
particularly disruptive, as the first director was promoted and a new director was hired but then
resigned and had to be replaced. During this same period—between the 1997 and 1999 site
visits—all home visitors and child care teachers at that program left and had to be replaced.
3. Staff Training and Educational Attainment
The revised Head Start Program Performance Standards require programs to establish
and implement a structured approach to staff training that is designed to help build
relationships among staff and provide them with the skills they need to do their jobs. We
rated programs as fully implemented in this area if all staff received training in multiple
areas and if training was provided according to a plan based on an assessment of staff
training needs. The 1998 Head Start reauthorization required that, by September 2003,
at least 50 percent of all Head Start and Early Head Start teachers nationwide in center-
based programs have an associate’s degree, a bachelor’s degree, or an advanced
degree in early childhood education or development, or a degree in a related field and
experience in teaching preschool children. In addition, the standards require that Early
Head Start teachers obtain a CDA credential for infant and toddler caregiver within one
year of their hire as a teacher of infants and toddlers.5
5
The CDA credential is designed to ensure that the CDA is able to meet the specific needs
of children and is able to work with parents and other adults to nurture children's physical, social,
emotional, and intellectual growth in a child development framework. CDAs must be high
142
Based on information gathered in site visit interviews and focus groups with program staff,
we rated each program’s degree of implementation in the area of training by considering the
extent to which programs provided staff with training in multiple areas according to a plan based
on an assessment of staff training needs. In fall 1999, 15 research programs had fully
implemented the staff training requirements (Figure VII.2), up from 12 programs in fall 1997.
Thirteen research programs had reached an enhanced level of implementation in this area—their
approach to staff training extended to emphasizing relationship-building and provided
opportunities for practice, feedback, and reflection. One program was rated as moderately
implemented in this area because part-time staff did not participate in most staff training
sessions, and another program was rated as moderately implemented because it provided initial
training but did not provide adequate opportunities for ongoing training throughout the year.
Most programs reported conducting assessments of staff training needs. Almost all
surveyed their staff members annually so that the individual staff members could give their
perceptions of areas in which they needed additional training and support. Center-based
programs also observed teachers working in their classroom settings, and supervisors in home-
based programs accompanied home visitors to observe home visit activities directly. Program
(continued)
school graduates or have a GED, be 18 years or older, and have 480 hours of experience working
with children within the previous 5 years. They must attend 120 hours of formal
education/training at an approved institution. Training must include at least 10 hours in each of
8 content areas: (1) planning a safe, healthy, learning environment; (2) advancing children's
physical and intellectual development; (3) supporting children's social and emotional
development, (4) establishing productive relationships with families; (5) managing an effective
program operation; (6) maintaining a commitment to professionalism; (7) observing and
recording children's behavior; and (8) understanding principles of child growth and development.
Each CDA’s advisor observes the candidate working with children for a minimum of two hours
and completes an assessment that is forwarded to the national CDA office, which then schedules
a written test and oral interview. The CDA office forwards results to the Council for
Professional Recognition, which issues the CDA credential.
143
directors and coordinators also used their group and individual supervision meetings to assess
areas in which staff development was needed. Several program supervisors maintained a
professional development plan for each staff member. Staff training needs were also typically
judged in relation to the needs of the families the program served. For example, a program
serving families whose children presented particular disabilities would offer specialized training
for its staff.
We obtained information on staff educational attainment from the staff survey and report it
here to augment the picture of Early Head Start staffing based on the site visits. It was not
included in the implementation ratings. Responses to the staff survey show that Early Head Start
staff members in the research sites were generally highly educated (Table VII.2). In fact,
overall, the 17 research programs were more than meeting the requirement of the Head Start
reauthorization: 55 percent of frontline staff and 62 percent of all staff had at least a two-year
degree. Furthermore, 50 percent of all staff had completed at least a four-year college degree in
1999 (this includes 3 percent who had taken some graduate courses, 13 percent with a graduate
degree, and 6 percent with some other post-baccalaureate or master’s certificate). Eleven percent
held a two-year college degree as their highest level of education, 14 percent had taken some
college courses, and only 3 percent had not completed high school.
Educational attainment and certification of staff varied by program approach and by site,
with home-based and mixed-approach programs having the highest average educational
attainment. The percentage of staff with a four-year degree or higher was 28 percent in center-
based, 60 percent in mixed-approach, and 63 percent in home-based programs. Site-to-site
variation was wide, with, at the high end, 100 percent and 85 percent of staff having a four-year
or higher degree at two home-based programs, and 84 percent at a mixed-approach program; in
two programs—both center-based—just 24 percent of staff had a bachelor’s or higher degree. In
144
TABLE VII.2
EARLY HEAD START STAFF EDUCATIONAL ATTAINMENT AND PARTICIPATION IN TRAINING,
FOR THE FULL SAMPLE AND BY PROGRAM APPROACH (PERCENTAGES)a
Program Approach in 1997
Range of
Full Percentage Center- Home- Mixed
Sample Across Programs Based Based Approach
All Staff
At Least a Two-Year Degree 62 28–100 38 74 73
At Least a Four-Year Degree 50 24–100 28 63 60
Participated in at Least One
Professional Training in Past Year 87 74–100 82 89 91
Training Rated “Very Beneficial” 76 44–100 76 86 67
Frontline Staff
Completed CDA or Higher 76 20-100 62 85 83
Currently in CDA Training 18 0-100 19 24 11
At Least a Two-Year Degree 55 13-100 34 73 65
At Least a Four-Year Degree 41 7-100 21 61 48
Participated in at Least One
Professional Training in Past Year 88 75-100 84 92 91
Rated Training “Very Beneficial” 73 40-100 74 86 63
SOURCE: Survey of program staff conducted in fall 1999.
a
Frontline staff members are all staff who work directly with children, typically teachers in center-based, home
visitors in home-based, and both in mixed-approach programs (N = 242).
145
one home-based program, 56 percent of staff had a master’s or other graduate degree, while there
were eight programs in which fewer than 10 percent of staff had advanced degrees.
Of particular interest is the degree to which programs succeeded in having their frontline
staff credentialed. In 1999, we were able to examine CDA credentialing separately for frontline
staff. Seventy-six percent of frontline staff reported having a CDA credential or a higher
degree.6 According to the staff members’ self-reports, in 1999, center-based programs appeared
not to be meeting the performance standards with respect to frontline staff attaining their CDA
credential. Among frontline center-based staff who had been in their position for at least one
year (and therefore required to have their CDA credential), 61 percent reported having a CDA
credential or higher degree (associate’s, bachelor’s, or graduate degree) (not shown in table).
Nineteen percent of center-based frontline staff members were currently participating in CDA
training, and another 29 percent reported planning to do so.
Most staff (87 percent overall, 88 percent of frontline staff) reported having participated in
at least one professional training activity in the past 12 months. Although training participation
was reported to be high in all types of programs, it was somewhat more common in mixed-
approach and home-based programs (91 and 89 percent of staff, respectively) than in center-
based programs (82 percent) (see top portion of Table VII.2). Three-fourths of all staff found the
training “very beneficial,” and almost 90 percent said they were somewhat or very likely to
change what they did in their work based on the training; staff in the three program approaches
differed little in this regard. Perception of the value of training varied considerably by the
6
In 1997, we were not able to provide data separately for frontline staff. Then, 14 percent of
all staff reported having completed a CDA credential; an additional 14 percent reported currently
participating in CDA training. In 1999, 24 percent of all staff reported having their CDA
credential (a 71 percent increase over the two-year period), and an additional 12 percent were in
training.
146
individual program, however, with more than 90 percent of staff in four programs finding
training to be “very beneficial”; in only two programs was this figure less than 60 percent. In
general, home-based staff members reported not only higher levels of educational attainment but
higher rates of participation in training (both CDA and other professional training) and rated
their training as more beneficial than did staff in other programs. This was especially the case
among frontline staff who work directly with children and families.
Many programs make special efforts to tailor their training to the needs of their staff and
their families. Researchers Joseph Stowitschek and Eduardo Armijo, working with the
Washington State Migrant Council’s Early Head Start program, have documented the training
opportunities that the program has provided to its largely Hispanic farm-working families, as
well as the results they have achieved. Their research is summarized in the box below and
reported in greater detail in Appendix C.
4. Compensation
The Advisory Committee on Services to Families with Infants and Toddlers noted that
high-quality staff performance and development are associated with salary,
compensation, and career advancement (U.S. Department of Health and Human
Services 1994). The Early Head Start grant announcement emphasizes the importance
of adequate staff compensation to promote staff retention and to reward high-quality
performance and professional development. We rated programs as fully implemented in
this area if directors reported that staff salaries and benefits were above the average
level for similar staff in other community programs.
Ten research programs were rated as fully implemented in the area of staff compensation, up
from eight in fall 1997 (Figure VII.2). Of these, six had achieved an enhanced level of
implementation—in addition to above-average staff compensation, their staff received tuition
reimbursement, child care, or other “family-friendly” benefits. Seven programs were rated as
moderately implemented in this area in fall 1999 because staff salaries and benefits were not
reported to be higher than the average level for similar staff in community programs.
147
OUTCOMES IN STAFF DEVELOPMENT AT THE WASHINGTON STATE MIGRANT COUNCIL EARLY
HEAD START PROGRAM
Joseph J. Stowitschek and Eduardo J. Armijo
University of Washington
Staff development is identified as one of the “cornerstones” of Early Head Start (along with an emphasis on children,
families, and communities), and is a major component of the Washington State Migrant Council’s (WSMC) Early Head
Start project. A qualified, well-trained staff with opportunities for growth and development would be essential to ensure
that the diverse needs displayed by the program’s migrant and Hispanic farm-working families are met.
The WSMC staff has received training, as well as educational incentives, to promote competence in such areas as
brain development, conflict and anger management, proper food preparation, disabilities, and transition services. A staff
development interview provided data on staff members’ educational goals and career aspirations, training, and incentives
and disincentives for personal and professional growth. A family services questionnaire provided data pertaining to
service delivery focus areas and methods. Respondents were six home educators, two case managers, and WSMC project
coordinator, and the project director. Findings center on staff educational goals and career aspirations, training, and
incentives and disincentives.
Staff Educational Goals/Career Aspirations. To help staff meet their goals of attaining bachelor’s degrees, WSMC
offered incentives to encourage staff to continue with their education. These included an education-reimbursement
package for tuition, books, mileage, and child care, and flex time schedules to accommodate coursework. On a 5-point
scale of degree of encouragement, staff uniformly gave WSMC’s efforts the highest possible rating, a “5.” Many staff
educational goals directly related to career aspirations. When asked about the future, staff mentioned positions included
running a certified day care center, full-time case management, Head Start or public school teaching, family program
coordination, and program or public school administration.
Training. WSMC emphasized staff development through training, both within and outside the agency, in the areas
mentioned above. Staff received an average of nearly 55 hours of training in the preceding year. Staff members rated
their training as significantly contributing both to their professional skills and to career advancement.
Incentives and Disincentives. Personnel were asked about job-related incentives (such as pay and outside trainings),
in-service training provided by WSMC, attitudes of coworkers, and attitudes of WSMC supervisors and administrators.
On a 5-point scale, staff rated job-related incentives at 4.1, WSMC training at 3.9, coworker attitudes at 3.2, and
supervisors/administrators attitudes at 4.0. In open-ended questions, staff indicated that WSMC strongly encouraged
growth in these areas. In addition, many staff feel they have been personally enriched by the program in such areas as
raising their own children, reaching out to families in need, and increasing their own self-esteem and self-confidence.
Discussion. WSMC Early Head Start is highly committed to the staff development cornerstone as a means of
improving services for families. Staff uniformly indicated that the incentives received as part of their jobs had a positive
effect with the families they worked with. For example, over a three-year period, staff reported 26 percent average
increases in hours spent with families as part of regular visits, as well as over 300 percent average increases in hours spent
training families in project-related areas (such as child development and proper food preparation). In addition, staff
reported nearly 400 percent average increases in contact with families over the phone.
During the same three-year period, the focus has increased in the percentage of time spent in the areas of mental
health, nutrition, child language development, and father involvement. Staff also reported an increase in the percentage of
time spent in the specific areas of coaching families, providing praise and feedback to families, problem solving, assessing
and evaluation, providing verbal pointers, and arranging resources for families. Because most of the Early Head Start staff
have the same Hispanic roots as the families they served, their professional successes and advancements reflect the hopes,
aspirations, and opportunities that are strived for with these younger, poorer Hispanic families.
148
At the time of the fall 1999 site visits, several programs were in the process of increasing
salaries and revising them to reward staff who obtained associate’s degrees. In most of these
programs, however, the new rates had not yet been implemented or had been implemented only
recently. Nevertheless, according to the staff survey, the average hourly wage of frontline staff
increased by 9 percent over two years, from $9.77 per hour in 1997 to $10.68 in 1999 (Table
VII.3).7 Wages differed greatly across the individual programs and by program approach.
Classroom teachers in center-based programs received the lowest average wage among frontline
staff ($9.86 per hour). Center-based programs also had the greatest variation of any program
approach, ranging from $7.76 per hour in a Southern site to $16.41 at a program in the
Northeast). Home visitors were the highest-paid frontline workers, averaging $12.00 per hour,
but hourly wages of home visitors ranged widely across the seven home-based programs, from a
low of $9.43 in one site to $15.12 in another. As might be expected, frontline staff in mixed-
approach programs averaged in the middle, earning a reported $10.70 per hour, with a range
across these programs from $7.73 to $13.34.
Several programs significantly increased compensation for frontline staff between 1997 and
1999, with the number of programs paying above $14.00 on average increasing from one to
three. However, in 1999 four programs paid frontline staff less than $10 per hour, on average.
Across all staff, including program administrators, the 1999 average hourly wage was $12.59.
According to staff reports, Early Head Start programs provided a range of important fringe
benefits (Figure VII.3). At least three-fourths of all staff reported receiving six different
benefits. The most common were paid holidays (which 95 percent of staff reported receiving),
7
Frontline staff members were those whose job titles reported on the survey indicated that
they worked directly with children and/or families. Of the 356 staff responding to the survey in
1997, 228 were considered frontline (64 percent). Of the 416 responding in 1999, 242 (58
percent) were classified as frontline staff.
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TABLE VII.3
EARLY HEAD START STAFF COMPENSATION AND FRINGE BENEFITS, FOR THE FULL SAMPLE
AND BY PROGRAM APPROACH
Program Approach in 1997
Full Range Across Center- Home- Mixed
Sample Programs Based Based Approach
All Staff
Hourly Wage $12.59 $8.25–$17.73 $11.43 $13.47 $12.99
Percentage of Staff Reporting:
Health Insurance 83 50–100 76 85 86
Health Insurance for Dependents 54 20–91 42 61 59
Life Insurance 67 13–100 33 81 87
Dental Insurance 66 0–100 47 67 84
Paid Vacation Time 88 63–100 77 96 91
Paid Holidays 95 75–100 96 97 91
Compensation for Overtime 42 0–77 46 31 50
Paid Sick Leave 88 55–100 79 89 95
Educational Stipends 71 35–91 61 65 85
Paid Release Time for Training 95 85–100 90 96 97
Retirement Plan 77 0–100 56 89 85
Child Care for Own Children 10 0–39 16 1 14
Frontline Staff
Hourly Wage $10.68 $7.73–$16.41 $9.86 $12.00 $10.70
SOURCE: Survey of program staff conducted in fall 1999.
150
FIGURE VII.3
FRINGE BENEFITS RECEIVED BY STAFF
IN EARLY HEAD START RESEARCH PROGRAMS,
FALL 1997 AND FALL 1999
Benefit
Paid health insurance 86
83
Paid health insurance--dependents 58
54
Life Insurance 74
67
Dental insurance 76
66
Paid vacation 88
88
Paid holidays 92
95
Compensation for overtime 33
42
Paid sick time 93
88
Educational stipends 73
71
Paid release time to attend training 92
95
Retirement benefits 75
77
0 20 40 60 80 100
Percentage of Staff Members
Fall 1997 Fall 1999
SOURCE: Self-administered surveys of staff completed during visits to the Early Head Start research
programs in fall 1997 and fall 1999.
151
paid release time to attend training (also 95 percent), paid sick leave (88 percent), paid vacation
time (88 percent), health insurance (83 percent), and retirement benefits (77 percent). Seventy-
one percent reported receiving educational stipends. Fewer staff reported receiving dental
insurance, health insurance for their dependents, life insurance, or compensation for overtime
work. The benefit picture did not change substantially between 1997 and 1999 (8 of the 11
benefits we asked about did not change by more than 5 percentage points). The exceptions were
paid life and dental insurance, which declined by 7 and 10 percentage points, respectively, and
compensation for paid overtime, which increased substantially across all programs, from 33 to
42 percent of all staff reporting that they received this benefit).
The benefits picture for Early Head Start staff was somewhat dependent on the program
approach of the program in which they worked. Of the 11 benefits shown in Figure VII.3 and
Table VII.3, 7 were most prevalent in mixed-approach programs, and in 4 cases it was staff in
home-based programs that were most likely to report receiving a benefit. However, in most
cases the difference between these two program approaches was small (Table VII.3). In most
areas, center-based programs provided benefits to a substantially smaller percentage of staff than
did either of the other two program approaches. For example, 56 percent of center-based staff
reported receiving a retirement or pension plan, whereas 85 percent of mixed and 89 percent of
home-based staff reported retirement benefits; 47 percent of center-based staff received dental
insurance, compared with 67 percent of home-based staff and 84 percent of staff in mixed-
approach programs. A few benefits that were very common overall differed little by program
approach: in all three types of programs, more than 90 percent of staff reported receiving paid
holidays and paid release time to attend training. One of the less-common benefits was provision
of free child care for children of the staff. Center-based and mixed-approach programs were
most likely to provide this benefit (reported by 16 and 14 percent of staff, respectively), while
152
only 1 percent of home-based staff reported receiving a child care benefit. In a number of ways,
benefits are therefore seen to parallel wages and education levels across the program approaches.
5. Staff Morale
Staff morale is not specifically addressed in the revised Head Start Program
Performance Standards. We included it in the implementation ratings, however,
because it is an important measure of the extent to which programs created supportive
environments that enable staff to perform and develop. We rated programs as fully
implemented in this area if morale was high or very high at the time of the site visit.
Based on staff reports during site visits and in staff surveys, nine programs were rated as
“fully implemented” in the area of staff morale in fall 1999, up from eight in fall 1997. Eight
programs were rated as moderately implemented in this area, because staff morale appeared to be
average.
To obtain detailed information about this important aspect of program operations, we
assessed “workplace climate” by including on the staff survey a number of questions that would
tell us how staff members in the research programs perceived key aspects of their employment
circumstances. Staff members generally reported a very positive view of their workplace (Figure
VII.4 and Table VII.4). Most reported that Early Head Start is a pleasant place to work.
Program directors received high marks from their staff: a large percentage of staff saw their
director as communicating a clear vision, providing realistic job expectations, keeping the staff
informed, and recognizing when the staff member does “a good job.” Similarly, very few staff
reported that they are required to follow rules that conflict with their best professional judgment;
only about one-quarter felt that routine duties and paperwork interfered with doing their jobs.
The area in which staff members were least satisfied, as might be expected, is salary: 42 percent
reported that they agreed or strongly agreed with the survey item, “I am satisfied with my
salary.” This percentage, however, increased from 1997 to 1999, while most of the responses to
workplace climate items changed little over this time (Figure VII.4).
153
FIGURE VII.4
WORKPLACE CLIMATE, FALL 1997 AND FALL 1999
Director communicates 84
clear vision 82
EHS is a pleasan 91
place to work 89
Director recognizes 73
when I do a good job 74
Director keeps me 77
informed 81
Director has realistic 78
expectations 79
Routine duties and 30
paperwork interfere with 27
job
Have to follow rules that 16
conflict with judgmen 20
Satisfied 38
with salary 42
0 20 40 60 80 100
Percentage of Staff Rating Agree or Strongly Agree
Fall 1997 Fall 1999
SOURCE: Self-administered surveys of staff completed during visits to the Early Head Start research programs
in fall 1997 and fall 1999.
154
TABLE VII.4
PERCENTAGE OF EARLY HEAD START STAFF AGREEING OR STRONGLY AGREEING WITH
STATEMENTS REGARDING THEIR PROGRAM’S WORKPLACE CLIMATE, FOR THE FULL
SAMPLE AND BY PROGRAM APPROACH
Program Approach in 1997
Range of
Full Percentage Center- Home- Mixed
Sample Across Programs Based Based Approach
Director Communicates Clear Vision 82 56–100 79 79 87
Early Head Start Is Pleasant Place to Work 89 55–100 93 82 94
Director Recognizes when I Do a Good Job 74 44–86 75 70 77
Director Keeps Me Informed 81 17–100 82 79 82
Director Has Realistic Expectations 79 64–88 78 80 78
Routine Duties and Paperwork Interfere with
Job 27 4–64 25 26 31
Have to Follow Rules That Conflict with
Own Judgment 20 0–40 25 15 21
Satisfied with Salary 42 14–82 42 46 38
Administrators Encourage Staff Development
Activities 86 73–100 80 88 88
Staff Frequently Share Ideas with Each Other 86 55–100 83 82 92
Staff and Administrators Work
Collaboratively for Program Improvement 78 64–96 74 81 78
Administrators Collaborate with Other Staff
to Make Decisions 69 52–86 65 74 68
Staff and Administrators Are Receptive to
Change 64 36–86 66 65 61
Staff Have Enough Opportunity to Influence
Decisions Affecting Their Work 55 35–82 50 60 56
SOURCE: Survey of program staff conducted in fall 1999.
155
A number of questions about workplace climate focused on the interrelationships of staff
and directors, collaboration, and decision making (Figure VII.5 and Table VII.4). Most staff
members (86 percent in both 1997 and 1999) felt that the program encouraged staff
development, a critical element for any human services program. A large percentage of staff
members (86 percent in 1999) worked in programs where their colleagues shared ideas with each
other, and 78 percent reported that staff and administrators worked together for program
improvement. Somewhat smaller numbers (about two-thirds) saw their program administrators
as collaborating with staff in decision making and being receptive to change. Slightly more than
half (55 percent) of all staff felt that they had “enough opportunity” to influence decisions that
affected their work. Although the percentage who perceived that they had to follow rules they
didn’t agree with was small (20 percent), it increased 4 percentage points from 1997.
Through two years of program growth and with increasing programmatic complexity, staff
members in the research programs generally maintained their positive view of Early Head Start
as a place to work, a view that we reported in Leading the Way. Two survey items about
workplace climate that staff members rated somewhat lower in 1999 than in 1997 related to
collaborative decision-making. The percentage agreeing that “administrators collaborate with
other staff to make decisions” fell from 75 to 69 percent, and the percentage saying “staff and
administrators work collaboratively for program improvement” declined from 83 to 78 percent.
These declines, though not large, might reflect a number of factors operating over this period,
including the increasing complexity of program designs, growth in the size of program staffs,
turnover of directors and frontline staff, and the evolving program designs.
Through our staff interviews, we learned about several key factors that appeared to account
for this generally good staff morale. Staff members talked about their conviction that they were
156
FIGURE VII.5
WORKPLACE CLIMATE: COLLABORATION, SHARING, AND DECISION MAKING
FALL 1997 AND FALL 1999
Administrators encourage 86
staff development activities 86
Staff frequently share 82
ideas with each other 86
Staff and administrators 83
work collaboratively for 78
program improvemen
Administrators collaborate with 75
other staff to make decisions 69
Staff and administrators are 72
receptive to change 64
Staff have opportunity to influence 57
decisions affecting their work 55
0 20 40 60 80 100
Percentage of Staff Rating Agree or Strongly Agree
Fall 1997 Fall 1999
SOURCE: Self-administered surveys of staff completed during visits to the Early Head Start research
programs in fall 1997 and fall 1999.
157
making a difference in the lives of children and families, felt that they got along well and
supported each other, received generous benefits, and had flexible work schedules. When
morale was poor, staff attributed it to such factors as the stress resulting from dealing with the
difficult problems their families faced, inadequate communication within the program, the
departure of a program director, and program expansions or moves.
6. Staff Health and Mental Health
Early Head Start staff members are generally healthy (Table VII.5). More than two-thirds
(71 percent) described their health as “very good” or “excellent” on a 5-point scale; only 3
percent reported it to be “fair” or “poor.” Furthermore, 31 percent reported their health as being
somewhat or much better than one year earlier, with only 8 percent saying it was somewhat or
much worse than a year ago (health stayed “about the same” for 61 percent of the staff). Health
problems did not appear to be a significant interference with work: one-fifth or fewer of Early
Head Start staff indicated that any of four problems with work were a result of their physical
health “during the past four weeks” (Table VII.5). Staff responded in a similar fashion to a
question as to whether, in the past four weeks, they had a number of work difficulties “as a result
of emotional problems, such as feeling depressed or anxious” (Table VII.5).
Finally, staff members reported on the extent to which their “physical health or emotional
problems” interfered with their normal social activities with family, friends, neighbors, or
groups. Ninety percent reported that they interfered “slightly” or “not at all.” Although
considerable site-to-site variation appeared, there were no systematic differences in reported
physical and emotional health by staff in the three program approaches.
158
TABLE VII.5
STAFF HEALTH AND MENTAL HEALTH: PERCENTAGE OF EARLY HEAD START STAFF
RESPONDING “YES” TO SURVEY STATEMENTS, FOR THE FULL SAMPLE
AND BY PROGRAM APPROACH
Program Approach in 1997
Range of
Full Percentage Center- Home- Mixed
Sample Across Programs Based Based Approach
Overall Health
Health Is “Very Good” or “Excellent” 71 38–91 76 66 71
Health Is Somewhat or Much Better than One
Year Ago 31 15–45 19 36 28
Problems as Result of Physical Health
“During Past Four Weeks”
Did you cut down the amount of time you
spent on work or other activities? 9 0–16 7 10 8
Did you accomplish less than you would
have liked? 20 9–31 21 18 22
Were you limited in the kind of work or other
activities you were able to do? 10 0–17 9 12 10
Did you have difficulty performing work or
other activities, for example, did it take
extra effort? 12 0–29 10 15 11
Problems as Result of Emotional Problems
“During Past Four Weeks”
Did you cut down the amount of time you
spent on work or other activities? 7 0–29 6 10 4
Did you accomplish less than you would
have liked? 16 4–35 19 17 13
Did you not work or perform other activities
as carefully as usual? 11 0–27 14 14 6
In Past Four Weeks, Physical Health or
Emotional Problems Interfered with Normal
Social Activities Slightly or Not at All 90 84–100 88 88 93
SOURCE: Survey of program staff conducted in fall 1999.
159
7. Job Satisfaction and Commitment
Responses to a number of questions about job satisfaction indicated that Early Head Start
staff members enjoyed their work, found it worthwhile, and agreed that their jobs used their
skills; few found their work boring. A sizable proportion said their work was “hard,” yet overall,
more than three-fourths were satisfied with their position in the program. Table VII.6 shows the
percentage of staff reporting that they agreed or strongly agreed with the job satisfaction
statements on the survey.
In spite of being generally happy with their jobs, at least some Early Head Start staff
members nevertheless found them stressful. About one-fourth of all staff members (24 percent)
reported that their jobs were usually or always stressful. This varied considerably across
programs, ranging from a low of just 9 or 10 percent of staff saying their jobs were usually or
always stressful at three sites to 50 and 56 percent with this response at two sites. The latter two
programs were home-based and, overall, the highest levels of stress were reported by home-
based program staff (on average, 31 percent rated their jobs as usually or always stressful) and
the lowest for center-based staff (18 percent). This is consistent with the fact that home-based
staff are faced with coping directly with families’ day-to-day problems more often than are
center-based staff.
Early Head Start staff generally had somewhat mixed feelings about their position with their
program (Table VII.6). While 71 percent responded, “no,” they did not intend to “leave this
field” in the next year (just 4 percent said yes to that question), 45 percent responded that they
did not “feel committed to working in this field” (26 percent indicated they did feel committed to
their field). As the job satisfaction responses also indicated, however, staff members put a lot of
effort into their work and generally did not feel like quitting (only 7 percent indicated they
frequently felt like quitting).
160
TABLE VII.6
JOB SATISFACTION AND COMMITMENT: PERCENTAGE OF EARLY HEAD START STAFF
RESPONDING TO SURVEY STATEMENTS, FOR THE FULL SAMPLE
AND BY PROGRAM APPROACH
Program Approach in 1997
Range of Mean
Full Percentage Center- Home- Mixed
Sample Across Programs Based Based Approach
Percentage Agreeing or Strongly Agreeing
I enjoy my work 95 81–100 99 93 91
I find my work worthwhile 94 84–100 95 95 93
I find the work that I do is hard 41 0–70 30 47 45
I find my work boring 3 0–17 5 9 2
The work I do uses my skills 91 76–100 90 90 93
I am satisfied with my position with the Early
Head Start program 77 56–100 77 79 74
Percentage Responding “Yes”
I intend to leave this field in the next year 4 0–13 4 5 2
I put a lot of effort into my work 99 93–100 99 99 99
I frequently feel like quitting 7 0–24 6 8 6
I feel committed to working in this field 26 14–50 30 20 27
I feel stuck in this position due to few other
employment opportunities 14 0–32 13 17 13
Job is usually or always stressful 24 9–56 18 31 22
SOURCE: Survey of program staff conducted in fall 1999.
161
Although responses varied by site, this variation was not as great as on some of the other
staff survey questions. Differences by program approach are not substantial, with the percentage
of staff agreeing to these items differing by only a few percentage points across the three
program approaches, but a trend suggests that staff of home-based programs experience greater
stress than staff in other programs.
C. IMPLEMENTATION OF MANAGEMENT SYSTEMS AND CHANGES FROM
1997 TO 1999
The Early Head Start research programs’ implementation of management systems improved
substantially during the evaluation period. The number of programs that had achieved full
implementation of management systems doubled from 7 programs in fall 1997 to 14 in fall 1999
(Figure VII.6).
1. P
olicy Councils
The revised Head Start Program Performance Standards require programs to establish
Policy Councils that develop and approve key program policies and procedures. Policy
Councils must include parents and community members. At least 51 percent of the
members must be parents of currently enrolled children.
The number of research programs that had fully implemented these Policy Council
requirements doubled between fall 1997 and fall 1999, from 8 to 16 (Figure VII.7). Ten
programs had reached an enhanced level of implementation by fall 1999—their Policy Councils
met regularly and made decisions about many aspects of the program. One research program
received a low implementation rating on this dimension because, although it had established a
Policy Council, it did not meet regularly.
2. Goals, Objectives, and Plans
To ensure careful and inclusive planning, the revised Head Start Program Performance
Standards require programs to develop multiyear goals, short-term objectives, and
written plans for implementing program services.
162
FIGURE VII.6
EARLY HEAD START MANAGEMENT SYSTEMS
IMPLEMENTATION RATINGS
Number
of Programs
10
10
Partial Implementation Full Implementation
9
8
7
7
6
6
5
4
4
163
3
2 2 2
2
1
1
0 0
0
1 2 3 4 5
Minimal Low-Level Moderate Full Enhanced
Implementation Implementation Implementation Implementation Implementation
Ratings
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 17 Early Head Start research programs.
Note: Implementation ratings for management systems represent the average rating across all the dimensions we examined. Programs
rated as fully implemented achieved full implementation in most of the dimensions we examined, but did not necessarily achiev
full implementation in every dimension.
FIGURE VII.7
EARLY HEAD START MANAGEMENT SYSTEMS
ASPECTS THAT WERE FULLY IMPLEMENTED
Number of Programs
that Reached Full
Implementation
17 16
16 15 15
15
14 13 13
13 12
12
11
10
164
9 8
8 7
7 6
6
5
4 No
3 Rating
2 in 1997
1
Policy Council Goals, Objectives, Self-Assessment Community Needs Communication
and Plans Assessment Systems
Aspects of Management Systems
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 17 Early Head Start research programs.
In fall 1999, 13 research programs had fully implemented these planning requirements,
almost doubling from the 7 programs that were fully implemented in fall 1997 (Figure VII.7).
Seven programs had reached an enhanced level of implementation of the planning requirements
in fall 1999—they developed their goals and plans in consultation with Policy Councils, advisory
groups, parents, staff, and community members. Two programs received a rating of “moderately
implemented” because their goals, objectives, and plans needed to be updated. Two programs
received a low implementation rating in fall 1999 because, although they had implemented a
planning process, their goals and plans had been only partially implemented.
3. Program Self-Assessment
To promote continuous improvement, the revised Head Start Program Performance
Standards require programs to assess annually their progress toward achieving their
goals and their compliance with the standards. The self-assessment should include
Policy Council members, parents, staff, and other community members.
The number of programs that had fully implemented these self-assessment requirements
doubled between fall 1997 and fall 1999, from 6 to 12 (Figure VII.7). Six programs had reached
an enhanced level of implementation of the self-assessment requirements in fall 1999; these
programs had used the results of their self-assessments to make specific program improvements.
Three programs reached a moderate level of implementation in this area in fall 1999; while they
had conducted some self-assessment activities in the past year, the self-assessment process
needed to be formalized and documented in program records. One program received a low
implementation rating in this area in fall 1999 because it had developed a plan for conducting a
self-assessment but had not yet implemented it. One program had not yet planned for or
conducted a self-assessment.
165
4. Community Needs Assessment
The revised Head Start Program Performance Standards require programs to conduct
an assessment of community strengths, needs, and resources at least once every three
years.
Fifteen research programs had fully implemented the community needs assessment
requirements in both fall 1997 and fall 1999 (Figure VII.7). Seven had reached an enhanced
level of implementation of the community needs assessment requirements in fall 1999—they
involved a wide range of Policy Council and advisory group members, staff, parents, and
community members in the assessment process. One program had conducted a community
needs assessment, but it had not updated the assessment within the past three years. Another
program had not yet carried out its plans for conducting a community needs assessment.
5. Communications Systems
We rated programs as fully implementing communication systems if systems were in
place for communication among program staff, between staff and parents, with the
grantee agency, and with the Policy Council and other governing bodies.8
In fall 1999, 13 programs had fully implemented communication systems, including
meetings and written communications on paper and through e-mail. Eight programs reached an
enhanced level of implementation of communication systems—their systems facilitated two-way
communication in which staff, parents, the Policy Council, and the grantee provided information
and input and also received it from each other. Four programs received a rating of “moderately
implemented” in fall 1999 because they did not have adequate systems in place for
communicating with the grantee agency, Policy Council, or other governing bodies.
8
We did not rate this dimension in 1997. We added the scale for communication systems in
1999 based on the recommendation of a member of the training and technical assistance
network.
166
D. SUMMARY
The Early Head Start research programs made significant strides in staff development and
program management. Almost all (15 out of 17) achieved a rating of full or enhanced
implementation in staff development by fall 1999, and the 3 programs that had been rated “low”
in 1997 improved by 1999. Fourteen programs were rated as fully implemented in Early Head
Start management systems in 1999, and 3 of the 4 that had been “minimal” or “low” in 1997
received higher ratings in 1999. The strongest areas across staff development and management
were supervision, staff training, Policy Councils, and community needs assessments—in each of
these, 15 or more programs were rated as fully implemented in 1999. Although staff retention
was lower in 1999 than in 1997, most programs experienced annual turnover in the 15 to 32
percent range, and improvement was seen in the fact that fewer programs experienced very high
turnover rates. A number of programs focused on improving wages, and the average
compensation for frontline staff improved by 9 percent over that two-year period. Staff
responses to a survey administered in fall 1999 showed that staff morale was generally high.
Staff reported positive workplace climates and valued their directors.
The three program approaches differed in some aspects of staff development. Staff in home-
based and mixed-approach programs had higher levels of educational attainment than those in
center-based programs, the frontline staff in these programs received higher wages, and home-
based and mixed-approach programs provided better benefits packages. Overall, programs were
successful in meeting the requirement of the performance standards that at least 50 percent of
frontline staff have a two-year or higher degree, even before the 2003 deadline. However,
center-based programs were not achieving the required goal of having all teachers CDA-certified
within a year of being hired. The three program approaches did not differ substantially in staff
health and mental health, nor did they differ greatly in their staff’s job satisfaction ratings,
167
although satisfaction was somewhat lower among home-based staff. Many staff across the
research programs believed they were making a difference in the lives of children and families.
168
VIII. THE QUALITY OF SELECTED CHILD DEVELOPMENT SERVICES
An important dimension of program implementation is the degree to which programs offer
high-quality services. The Early Head Start program guidelines specifically require programs to
provide high-quality early education services, home visits, and parent education, and to ensure
that infants and toddlers who need child care receive high-quality care. The guidelines also
require programs to ensure that the full range of family-oriented services is of high quality.
Our examination of quality focuses on two important child development services—child
care and child development home visits—because these are core Early Head Start services, and
measurement tools existed or could be developed for assessing their quality. We begin this
chapter by describing our methods for assessing the quality of core child development services,
and then report on the progress programs made in improving the quality of these services
between fall 1997 and fall 1999.
A. METHODS FOR ASSESSING QUALITY
We used two main methods for assessing the quality of core child development services.
First, we assessed the quality of child care used by Early Head Start families using data from
observations of the child care settings used by Early Head Start children. Second, we developed
rating scales and a rating process similar to those used for assessing implementation (see Chapter
IV) to rate inputs to the quality of child care in Early Head Start centers, programs’ efforts to
assess and monitor quality in community child care settings and to support child care providers,
and inputs to the quality child development home visits. In this section we describe the data
sources and analytic methods we used to rate inputs to the quality of child care and home visits
and to assess child care quality.
169
1. Rating Inputs to Quality
We developed scales for rating the “inputs to quality” of child care and child development
home visits. The literature on child care research indicates that researchers take a variety of
approaches to defining quality in child care (Love, Schochet, and Meckstroth 1996). Some
define quality as including such factors as staff qualifications and retention or stability (Ferrar
1996; Ferrar et al. 1996; and Phillips and Howes 1987); others consider these as contributors to
program quality (for example, Layzer et al. 1993). We adopted the latter approach in the Early
Head Start evaluation, considering elements that support what happens in classrooms or in home
visits to be “inputs to quality.” For child care, the inputs we rated were curriculum, assignment
of primary caregivers, educational attainment of teachers, and teacher turnover. For home visits,
the inputs we rated were supervision, home visitor training, home visitor hiring, planning home
visits, frequency of home visits, emphasis on child development, and integrating home visits
with other services. We also developed a scale for rating all programs on the extent to which
they monitored the quality of child care arrangements and provided training and support for child
care teachers.
We used data from site visits conducted in fall 1997 and fall 1999 to assign ratings to
programs. To facilitate the assignment of ratings, we assembled site visit data into checklists
organized according to the inputs to quality we rated (Appendix A).
2. Observations of Child Care Quality
We used data from observations of Early Head Start children’s child care settings (including
Early Head Start centers, community child care centers, and family child care homes) conducted
170
when they were 14 and 24 months old to assess the quality of child care that children received.1
These observations include data collected using a slightly shortened version of the Infant-
Toddler Environment Rating Scale (ITERS; Harms et al. 1990) and the Family Day Care Rating
Scale (FDCRS; Harms and Clifford 1989), as well as observed child-teacher ratios and group
sizes. These scales are widely used and consist of 35 items to assess the quality of care.2 These
scales produce scores on each item ranging from 1 to 7, in which 3 is described as minimal care,
5 as good care, and 7 as excellent care.
To compute average ITERS scores for Early Head Start centers, we began by averaging the
observations for each classroom.3 Classrooms were observed as often as once per quarter (or
more often if staff or children had changed since the last observation), depending on when Early
Head Start children were in care. We then averaged the classroom scores for each center. If a
program operated multiple centers, we averaged the center scores to generate an average
program score. Thus, the average ITERS scores reported here do not reflect the average quality
of care received by individual children. Rather, they represent the average quality of Early Head
Start centers, determined at the classroom level.
To compute average ITERS scores for community child care centers, we computed an
average score for each center, and then averaged the center scores to compute an average site
score. Likewise, to compute average FDCRS scores, we computed an average score for each
family child care home, and then averaged these home scores to compute an average site score.
1
Observations subsequently conducted when children were 36 months old are reported in a
separate paper on child care.
2
The shortened version of the ITERS we used excludes three items from the adult needs
category (opportunities for professional growth, adult meeting area, and provisions for parents).
3
The average ITERS and FDCRS scores reported here have not been weighted to reflect the
number of program children participating in each classroom, center, or home.
171
Observed child-teacher ratios and group sizes were calculated based on child and adult counts
taken during structured observations of child care settings.
B. INPUTS TO CHILD CARE QUALITY
In fall 1999, more than half of the 12 Early Head Start research programs with child care
centers received good or high ratings on several inputs to child care quality, including
curriculum, assignment of primary caregivers, and educational attainment of Early Head Start
teachers (Figure VIII.1). However, only two programs received a good or high rating on staff
turnover.
To receive a good rating for curriculum as an input to child care quality, Early Head Start
centers had to use a curriculum strongly integrated into the center’s daily activities and
appropriate for the population served. Centers that individualized their curriculum for each child
received a high quality rating. Eight out of the 12 research programs with centers received a
good or high quality rating on this dimension in fall 1999 (Figure VIII.1).
To receive a good rating for assignment of primary caregivers, Early Head Start centers had
to assign primary caregivers to children and adhere to these assignments throughout the day. In
addition, primary caregivers had to conduct almost all routine care activities for the children in
their group. To receive a high rating, primary caregivers had to communicate regularly with
parents and plan the activities for children in their group. Eight out of the 12 research programs
with centers met the criteria for a good or high quality rating on this dimension in fall 1999.
To receive a good rating for educational attainment of teachers, most teaching staff in Early
Head Start centers had to have a CDA, an associate’s degree, or a bachelor’s degree, or be in
CDA training. To receive a high rating, all teaching staff had to have a CDA, an associate’s
degree, or a bachelor’s degree, or be in CDA training. Seven out of the 12 research programs
with centers met the criteria for a good or high quality rating on this dimension in fall 1999. On
172
FIGURE VIII.1
NUMBER OF PROGRAMS WITH CENTERS IN WHICH INPUTS TO QUALITY
WERE RATED AS GOOD OR HIGH
Number of Programs
12
11
10
9
8 8
8
7
7
173
6
5
4
3
2
2
1
Curriculum Assigning Educational Teacher Retention
Primary Attainment of in EHS Centers
Caregivers EHS Teachers
Aspects That Were of Good or High Quality
Source: Site visits conducted in fall 1999 to 12 Early Head Start research programs with centers.
average, 58 percent of center staff had their CDA or higher degree in fall 1999, and an additional
19 percent were working on obtaining a CDA.
Only two programs with centers received a good or high rating in the area of teacher
retention, which required the centers’ teacher turnover rate to be below 20 percent for the
previous year. On average, about 39 percent of full-time and part-time staff working directly
with children in Early Head Start centers left and were replaced during the year prior to the fall
1999 site visits.
We rated all 17 research programs on two types of inputs to child care quality—quality
monitoring and training and support for providers—and in these areas, between one-fourth and
one-half of the programs received a good or high rating (Figure VIII.2). These ratings
encompass monitoring and teacher training and support in both Early Head Start centers and
other community child care settings.
To receive a good rating for quality monitoring, Early Head Start centers had to carry out
ongoing quality assessments and give feedback to staff about the care they were providing. To
receive a high rating, the approach to quality improvement had to be systematic. To receive a
good rating, programs in which some or all children received child care in community centers or
family child care homes had to (1) assess the quality of child care settings before referring
children, and (2) monitor child care quality regularly for most children in care, whether or not the
program placed the children in their child care settings. To receive a high rating, these programs
had to take a comprehensive approach to assessing quality and had to monitor quality regularly
for all children in child care. Seven out of the 17 research programs, including the 4 center-
based programs, met the criteria for a good or high quality rating on this dimension in fall 1999.
To receive a good rating for training and support of child care providers, programs had to
provide regular training to nearly all child care teachers and family child care providers caring
174
FIGURE VIII.2
EARLY HEAD START INPUTS TO CHILD CARE QUALITY
THAT WERE RATED GOOD OR HIGH
FALL 1999
Number of Programs
17
16
15
14
13
12
11
10
9
8 7
7
6
5 4
4
3
2
1
0
Monitoring Training and
Quality Support for
Child Care
Providers
Aspects That Were of Good or High Quality
SOURCE: Information gathered during visits to the Early Head Start research programs in fall 1999.
175
for Early Head Start children, and if some children were in relative care, the program had to
provide support and training to some of them as well. To receive a high rating, the program had
to provide the training according to individual needs and to base training activities on an
individualized training plan. Four out of the 17 research programs (the four center-based
programs) met the criteria for a good or high quality rating on this dimension in fall 1999.
C. OBSERVED CHILD CARE QUALITY
Child care observations were conducted in three settings that represent the range of
arrangements that Early Head Start children were in: (1) Early Head Start centers, (2) community
child care centers that Early Head Start children attended, and (3) family child care homes (both
regulated and unregulated) that Early Head Start children attended. In this section, we report on
child care observations conducted between October 1997 and September 1999 in Early Head
Start centers in 9 research sites, community child care centers in 16 research sites, and family
child care homes in 14 sites.
1. Quality in Early Head Start Centers
Our analysis indicates that the quality of care provided by Early Head Start centers during
their first three years of serving families was good (Table VIII.1). All programs scored above 4
on average, on the ITERS, with the average being 5.3 (in the good range) in both the first and
second years after the fall 1997 site visits.4
In most programs, the average ITERS score changed by only a few points, but in one
program it fell substantially (from 6.3 in the first year to 5.6 in the second year, still well within
4
The average for the first year has been updated since preliminary findings were presented in
Leading the Way, Volume III: Program Implementation (ACYF 2000a), because more
observations were received from data collectors.
176
TABLE VIII.1
EARLY HEAD START CHILD CARE QUALITY:
AVERAGE ITERS AND FDCRS SCORES BY PROGRAM
Early Head Start Centers (ITERS) Community Child Care Centers (ITERS) Family Child Care Homes (FDCRS)
Program 10/97-9/98 10/98-9/99 10/97-9/98 10/98-9/99 10/97-9/98 10/98-9/99
A -- -- -- 4.4 (1) 4.0 (7) 4.0 (5)
B -- -- 3.7 (6) 4.7 (7) -- 2.6 (2)
C 4.6 (14) 4.5 (11) 2.7 (1) 4.2 (3) 4.1 (2) --
D 4.2 (16) 4.4 (36) -- 5.9 (1) -- --
E 6.3 (8) 5.6 (4) 4.2 (3) 4.5 (7) 3.8 (6) 3.7 (8)
F -- -- 2.5 (1) 4.1 (3) 2.7 (3) 3.9 (1)
G 6.0 (4) 5.8 (3) -- -- 4.0 (13) 4.1 (14)
H 5.5 (2) 6.3 (3) 4.0 (5) 4.7 (11) 3.4 (6) 4.3 (7)
I 6.3 (4) 5.9 (36) 2.8 (2) 2.9 (9) 2.4 (1) 2.0 (2)
J -- -- 2.5 (3) 3.1 (1) 2.0 (1) --
K -- -- 4.5 (1) 5.0 (1) 3.7 (4) 3.3 (11)
L 5.5 (2) 5.7 (6) 3.1 (6) 3.4 (7) 3.2 (3) --
M -- -- 4.3 (7) 4.4 (10) 3.3 (4) 4.1 (4)
N 4.8 (14) 5.2 (14) 2.6 (2) 2.9 (4) 2.6 (2) 2.1 (1)
177
O 4.8 (32) 4.6 (17) 3.9 (2) 4.9 (3) -- 3.0 (1)
P -- -- 6.3 (3) 5.9 (3) 3.6 (7) 4.5 (2)
Q -- -- 5.2 (3) 5.7 (4) 3.9 (6) 4.5 (7)
Average 5.3 (96) 5.3 (130) 3.7 (45) 4.4 (75) 3.3 (65) 3.5 (65)
SOURCE: Based on classroom observations of the child care settings of program children conducted when children were 14 and 24 months old. The average scores include observations
received from the field from October 1997 through September 1999. The average scores for community child care centers and family child care homes may include observations
of child care arrangements that families chose on their own without assistance from the Early Head Start program or after dropping out of the Early Head Start program. The
numbers in parentheses represent the number of classroom or home observations conducted for each program and type of child care.
NOTE: The average scores shown here represent the average quality of Early Head Start and community child care settings, determined at the classroom level, used by program families.
Average scores for each program are not weighted to reflect the number of program children participating in each classroom, center, or home.
ITERS = Infant-Toddler Environment Rating Scale
FDCRS = Family Day Care Rating Scale
the good range), and in one program it rose substantially (from 5.5 to 6.3). Early Head Start
centers in several programs received average ITERS scores of 6 or above, which indicates good
to excellent care. Comparisons with other child care quality studies show that Early Head Start
centers were doing very well. For example, the Cost, Quality, and Child Outcomes Study Team
(1995) found that the average ITERS score across infant-toddler classrooms in the four states
studied was only 3.4, and 40 percent of the classrooms in that study received ratings below 3.0;
no Early Head Start center had an average score below 4.2 in 1997-1998 or 4.4 in 1998-1999
(Table VIII.1).
We also examined scores on subscales of the ITERS. The programs achieved good quality,
on average, in all areas, although scores were somewhat lower in three areas: learning activities,
adult needs, and furnishings (Figure VIII.3). Thus, programs may want to focus on these areas in
future quality enhancement efforts. Programs were particularly strong in the area of interactions:
three had average scores of 7.0 on this subscale.
Observed child-teacher ratios and group sizes were good in both time periods. Over time, as
the centers became fully enrolled and as more children were being observed at 24 months of age
rather than 14 months, average observed group sizes and ratios tended to increase slightly, but
they remained well below the thresholds set by the revised Head Start Program Performance
Standards (four children per teacher and eight children per group). Average child-teacher ratios
rose slightly, from 2.3 in the first year to 2.9 in the second year (Table VIII.2). Average group
sizes also rose slightly, from 5.3 to 5.9 (Table VIII.3).
2. Observed Child Care Quality in Community Child Care Centers
Our analyses suggest that the quality of child care received by Early Head Start children in
178
FIGURE VIII.3
EARLY HEAD START CENTERS
AVERAGE ITERS SUBSCALE SCORES, 1998-99
Average ITERS Score
7
6.0
6
5.7 5.7
5.6
5.2
5 4.8
4.6
179
4
3
2
1
Interactions Program Structure Listening Personal Care Furnishings Learning Adult Needs
and Talking Routines Activities
ITERS Subscale
Source: Observations of Early Head Start classrooms conducted in conjunction with child assessments at 14 and 24 months of age.
Note: Based on observations in 130 classrooms in 9 programs with centers.
TABLE VIII.2
EARLY HEAD START CHILD CARE QUALITY AVERAGE OBSERVED NUMBER OF CHILDREN PER TEACHER
Early Head Start Centers Community Child Care Centers Family Child Care Homes
10/97-9/98 10/98-9/99 10/97-9/98 10/98-9/99 10/97-9/98 10/98-9/99
A -- -- -- 5.3 (1) 4.5 (7) 2.5 (3)
B -- -- 3.9 (6) 3.7 (7) -- 4.5 (2)
C 1.9 (14) 2.2 (11) 6.8 (1) 2.3 (3) 2.2 (2) -
D 3.3 (16) 2.9 (36) -- 2.7 (1) -- --
E 2.5 (8) 2.8 (4) 2.8 (3) 4.4 (7) 2.8 (6) 3.6 (8)
F -- -- 3.6 (1) 3.1 (3) 6.8 (3) 4.0 (1)
G 2.7 (4) 3.5 (3) -- -- 3.8 (13) 4.5 (14)
H 1.3 (2) 3.2 (3) 4.7 (5) 4.5 (11) 2.0 (6) 2.0 (7)
I 2.8 (4) 2.9 (36) 3.0 (2) 6.3 (9) 4.0 (1) 1.7 (2)
J -- -- 4.0 (3) -- 1.0 (1) --
K -- -- 4.1 (1) 3.5 (1) 3.6 (4) 3.1 (11)
L 1.6 (2) 2.6 (6) 4.2 (6) 5.9 (7) 1.6 (3) --
M -- -- 5.3 (7) 4.4 (10) 5.6 (4) 6.1 (4)
N 2.3 (14) 2.3 (14) 6.0 (2) 8.2 (4) 1.0 (2) -
O 2.7 (32) 3.6 (17) 3.8 (2) 3.1 (3) -- 9.5 (1)
P -- -- 6.0 (3) 4.6 (3) 3.1 (7) 5.5 (2)
180
Q -- -- 4.0 (3) 4.3 (4) 4.6 (6) 3.3 (7)
Average 2.3 (96) 2.9 (130) 4.4 (45) 4.4 (74) 3.3 (65) 4.2 (65)
SOURCE: Based on classroom observations of the child care settings of program children conducted when children were 14 and 24 months old. The average ratios include observations
received from the field from October 1997 through September 1999 for all programs with at least three observations for a particular type of child care setting (Early Head Start
centers, community child care centers, or family child care homes). The average ratios for community child care centers and family child care homes may include observations of
child care arrangements that families chose on their own without assistance from the Early Head Start program or after dropping out of the Early Head Start program. The
numbers in parentheses represent the number of classroom or home observations conducted for each program and type of child care.
NOTE: The average ratios shown here are the average teacher-child ratios in Early Head Start and community child care settings, determined at the classroom level, used by program
families. Average ratios for each program are not weighted to reflect the number of program children participating in each classroom, center, or home.
TABLE VIII.3
EARLY HEAD START CHILD CARE QUALITY AVERAGE OBSERVED GROUP SIZE
Early Head Start Centers Community Child Care Centers Family Child Care Homes
10/97-9/98 10/98-9/99 10/97-9/98 10/98-9/99
10/97-9/98 10/98-9/99
A -- -- -- 9.0 (1) 4.6 (7) 3.0 (5)
B -- -- 5.5 (6) 8.9 (7) -- 6.7 (2)
C 5.9 (14) 7.1 (11) 13.7 (1) 6.7 (3) 5.9 (2) --
D 8.0 (16) 6.3 (36) -- 13.7 (1) -- --
E 5.9 (8) 6.1 (4) 5.8 (3) 10.9 (7) 2.9 (6) 4.1 (8)
F -- -- 8.7 (1) 8.1 (3) 6.8 (3) 4.0 (1)
G 5.2 (4) 5.2 (3) -- -- 5.0 (13) 5.3 (14)
H 2.5 (2) 6.0 (3) 7.9 (5) 7.6 (11) 3.1 (6) 3.2 (7)
I 5.5 (4) 4.8 (36) 3.9 (2) 8.7 (9) 4.0 (1) 2.9 (2)
J -- -- 10.7 (3) -- 1.0 (1) --
K -- -- 11.3 (1) 8.8 (1) 6.7 (4) 3.2 (11)
L 2.8 (2) 4.2 (6) 8.1 (6) 10.7 (7) 1.7 (3) --
M -- -- 8.1 (7) 6.9 (10) 6.5 (4) 6.9 (4)
N 5.2 (14) 5.9 (14) 11.5 (2) 13.8 (4) 1.0 (2) --
O 6.7 (32) 7.2 (17) 7.5 (2) 7.9 (3) -- 9.5 (1)
181
P -- -- 12.3 (3) 8.0 (3) 3.5 (7) 5.8 (2)
Q -- -- 9.8 (3) 6.3 (4) 6.5 (6) 5.0 (7)
Average 5.3 (96) 5.9 (130) 8.9 (45) 9.1 (74) 4.2 (65) 5.0 (64)
SOURCE: Based on classroom observations of the child care settings of program children conducted when children were 14 and 24 months old. The average group sizes include
observations received from the field from October 1997 through September 1999. The average group sizes for community child care centers and family child care homes may
include observations of child care arrangements that families chose on their own without assistance from the Early Head Start program or after dropping out of the Early Head Start
program. The numbers in parentheses represent the number of classroom or home observations conducted for each program and type of child care.
NOTE: The average group sizes shown here are the average group sizes in Early Head Start and community child care settings, determined at the classroom level, used by program
families. Average group sizes for each program are not weighted to reflect the number of program children participating in each classroom, center, or home.
community child care centers varied widely, but was consistently minimal, on average (Table
VIII.1).5 However, the average ITERS score for classrooms that we observed in community
child care centers was 3.7 in 1997-1998 and 4.4 in 1998-1999, indicating that the quality of care
in community child care settings may have improved over time.6 However, average quality
remained lower than the quality of care provided in Early Head Start centers.
The average child-teacher ratios in classrooms in community child care centers, 4.4 in both
the first and second years, exceeded the maximum ratio of four children per teacher specified in
the revised Head Start Program Performance Standards (Table VIII.2). Similarly, the average
group size in community child care centers, 8.9 in 1997-1998 and 9.1 in 1998-1999, exceeded
the maximum group size of eight children specified in the standards (Table VIII.3).
3. Observed Child Care Quality in Family Child Care Settings
Observational data suggest that the observed quality of child care that Early Head Start
children received in family child care settings was consistently minimal, but ratios and group
sizes were good.7 The average FDCRS score for the family child care settings was 3.3 in 1997
1998 and 3.5 in 1998-1999 (Table VIII.1), both in the minimal quality range. The average child-
caregiver ratio in the family child care settings that we were able to observe was 3.3 in the first
5
The community child care centers that we observed include both those that Early Head
Start assessed and monitored and those that parents selected without help from Early Head Start.
6
This change may indicate real improvement over time, but we are cautious in making this
interpretation because response rates were low in some sites. With fewer than three observations
in a number of sites, we may not have sufficient data to consider this to be a representative
sample of Early Head Start children’s community child care arrangements. In addition, it is
possible that higher quality scores are somewhat easier for centers to attain when serving older
children.
7
The family child care settings that were observed include both family child care homes that
Early Head Start assessed and monitored and family child care homes that parents selected
without help from Early Head Start.
182
year and 4.2 in the second (Table VIII.2). The average group size in the family child care
settings that we were able to observe was 4.2 children in the first year and 5.0 in the second
observation period (Table VIII.3).
D. INPUTS TO THE QUALITY OF CHILD DEVELOPMENT HOME VISITS
The inputs to the quality of child development home visits that we rated indicate that
overall, the quality of child development home visits improved substantially between the fall
1997 and fall 1999 site visits. By fall 1999, the quality of child development home visits in 11
research programs that served some or all families in a home-based option was rated as good or
high, up from 9 programs in fall 1997 (Figure VIII.4).
The greatest improvements in inputs to the quality of child development home visits were in
the areas of supervision, emphasis on child development, and home visit planning. In other
areas, most programs received high ratings in both fall 1997 and fall 1999.
The number of programs that were rated as providing good- or high-quality supervision of
home visitors increased from 8 programs in fall 1997 to all 13 programs in fall 1999 (Figure
VIII.5). The programs rated as providing good-quality home visitor supervision provided regular
individual and group supervision that included support, teaching, and evaluation; they also
provided mentoring. Supervisors paid some attention to child development, tracked the
frequency of home visits carefully, and accompanied home visitors on some home visits.
Programs rated as providing high-quality supervision also provided regular opportunities for
home visitors to discuss their experiences with peers, and supervisors had a regular plan for
accompanying home visitors on home visits.
The number of programs rated as providing good or high quality in terms of the number of
completed home visits per month increased from six to eight. The relatively small improvement
183
FIGURE VIII.4
EARLY HEAD START CHILD DEVELOPMENT HOME VISITS
OVERALL RATINGS OF QUALITY INPUTS
Number of Programs
13
12
11
10
9 9
9
8
7
6
184
5
4
4
3
2 2
2
1
0 0 0 0 0
0
1 2 3 4 5
Poor Quality Low Quality Moderate Quality Good Quality High Quality
Ratings
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 13 Early Head Start research programs providing home-based services to some or all families.
FIGURE VIII.5
EARLY HEAD START CHILD DEVELOPMENT HOME VISITS
RATINGS OF QUALITY INPUTS
Number of Programs
Rated as Good or
High Qualit 13 13
13
12 12 12
12
11 11
11
10
10
9
9
8 8
8
7
7
185
6
6
5
4
3
No
2 Rating
in 1997
1
Supervision Training Home Visitor Planning Frequency Emphasis Integrating Home-
Hiring Home Visits of Home on Child Based with
Visits Development Other Services
Aspects of Child Development Home Visits
Fall 1997 Fall 1999
Source: Site visits conducted in fall 1997 and fall 1999 to 13 Early Head Start research programs providing home-based services to some or all families.
in the number of programs with quality rated as good or high on this dimension reflects in part
the increase between 1997 and 1999 in the number of completed home visits required for a good
rating (from two to three per month). Thus, the small increase in the number of programs rated
as providing good or high quality understates the progress programs made in this area
The number of programs that were rated as good or high quality in terms of their emphasis
on child development during home visits increased from 7 to 10. In these programs, home
visitors were reported to spend at least half an hour during each home visit on child development
activities either with the child or with the child and parent together.
With respect to home visit planning, the number of programs rated as good or high quality
increased from 9 to 12. In programs receiving a good rating, home visits were planned based on
program goals and expected outcomes, and home visitors developed plans for each visit using a
curriculum or protocol to guide child development activities, which were then individualized to
meet the needs of individual parents and children. In programs that received a high quality
rating, home visitors also worked in partnership with parents to plan child development
activities.
E. SUMMARY
Between fall 1997 and fall 1999, the 17 research programs had notable success in providing
consistently good-quality care in Early Head Start centers. Although the observed quality of care
in community child care settings was somewhat lower, observation data indicate that quality in
community child care centers may have improved over time. In addition, programs made
considerable progress in improving key inputs to the quality of child care and child development
home visits between fall 1997 and fall 1999. The pathways that programs took as they worked
towards improving quality are examined in the next chapter.
186
IX. PROGRAM PARTICIPATION AND FAMILIES’ SERVICE NEEDS AND USE
The previous chapters examined the extent to which the Early Head Start research programs
implemented services that met the revised Head Start Program Performance Standards in key
areas. This chapter examines Early Head Start program services from the perspective of families
and their needs and goals (see descriptive data on families in Chapter I). We describe the data
used to examine participation and service needs and use; provide an overview of family
characteristics and needs; assess families’ levels and intensity of participation in Early Head
Start during the first 16 months after enrollment; detail their service needs and use in specific
areas, including the match between service needs and use; describe family engagement; and
relate families’ goals approximately 16 months after they enrolled in Early Head Start.1 We also
include brief reports from local research and program staff that provide local perspectives on
family engagement and participation in services.
A. DATA SOURCES
We drew on several data sources for analyses of service needs and use. These include:
• Head Start Family Information System application and enrollment forms completed at
the time of enrollment
• Parent services follow-up interviews targeted for 6 and 15 months after program
enrollment (completed an average of 7 and 16 months after enrollment). We included
in our analyses only families for whom data were available for both follow-up periods
(75 percent of research sample members).
1
The final report on early head start program impacts, Making a Difference in the Lives of
Infants and Toddlers and Their Families: The Impacts of Early Head Start (Administration for
Children and Families 2002), updates information in this chapter on levels and intensity of
program participation through 28 months after enrollment.
187
• Ratings of each family’s engagement with the program provided by program staff in
summer 2000, after most families had left the program and most children had reached
36 months of age
• Data on program characteristics and ratings of program implementation developed in
the implementation study
The follow-up period varied over a wide range for each of the parent services interviews.
The length of followup ranged from 4 to 15 months and averaged 7 months after enrollment for
the first follow-up interview. It ranged from 9 to 27 months and averaged 16 months after
enrollment for the second follow-up interview. However, approximately 90 percent of the first
follow-up interviews were conducted between 5 and 9 months after enrollment, and 88 percent
of the second follow-up interviews were conducted between 14 and 19 months after enrollment.
The questions on service use were broad, and to avoid substantial recall error, most did not
require families to recall detailed aspects of the services they received. For example, for most
services, families were asked whether or not they had received the service and how often they
received it, in broad ranges of frequency (such as weekly or monthly or on some other interval).
Because the parent services follow-up interviews were conducted according to the length of
time since families enrolled, the ages of the research sample children at the interview time
varied.2 On average, the focus children were 10 months old when the first follow-up interview
was completed and 20 months old when the second followup was completed. Children’s ages
ranged from 0 (unborn) to 25 months at the time of the first follow-up interview, and from 7 to
36 months at the second.
2
Parent interviews and child assessments were also conducted to measure child and family
outcomes when children were 14, 24, and 36 months of age; see the interim and final reports to
Congress (Administration on Children, Youth and Families 2001; Administration for Children
and Families 2002).
188
I
B. NVOLVING FAMILIES IN SERVICES: LEVELS AND INTENSITY OF
PROGRAM PARTICIPATION
Not only is it important for programs to implement and offer high-quality services, they
must also enroll families and engage them in program services. Engaging them in services
entails getting them to participate in program activities and gaining and sustaining their attention
and commitment to the goals of those activities. The following subsections examine levels of
participation by research families in program services during the first 16 months, on average,
after they enrolled in the Early Head Start research programs.3
1. Overall Participation Levels
Levels of participation in Early Head Start services were high during the first 16 months
after program enrollment. Overall, 93 percent of the research families received at least one Early
Head Start home visit, participated in Early Head Start child development centers, met with an
Early Head Start case manager at least once, and/or participated in Early Head Start group
activities (group parenting education, group parent-child activities, or a parent support group)
(Table IX.1). Nearly all these families received more than minimal services (more than one
home visit, more than one case management meeting, center-based child care, and/or group
parenting activities). Most families (86 percent) received core services through which child
development services were provided—home visits or center-based child development services.
Overall participation rates were high in most of the research programs. They exceeded 90
percent in 13 of the 17 programs (not shown), and in 2 of the remaining programs overall
participation rates were only slightly lower (88 percent).
3
Additional follow-up interviews were conducted approximately 26 months after enrollment
and at the time of program exit.
189
TABLE IX.1
RECEIPT OF KEY EARLY HEAD START SERVICES DURING THE FIRST 16 MONTHS, FOR THE FULL
SAMPLE AND KEY PROGRAM SUBGROUPS
Average Percentage of Families Who Received:
More than
At Least One Key Minimal Early More than Minimal
Early Head Start Head Start Early Head Start Core
Servicea Servicesb Servicesc Sample Sizes
Full Sample 93 91 86 1,052–1,133
Program Approach in 1997
Center-based 87 83 75 224–232
Home-based 94 93 89 487–534
Mixed-approach 94 93 90 341–367
Pattern of Implementation
Early implementers 97 96 94 368–389
Later implementers 92 90 86 387–427
Incomplete implementers 88 86 78 298–317
SOURCE: Parent Services Follow-Up Interviews conducted an average of 7 and 16 months after enrollment.
NOTE: Percentages are average percentages across programs in the given group and are weighted for survey
nonresponse.
a
Key services include home visits, case management meetings, center-based child development/child care services
and/or group activities such as parenting classes or group socializations.
b
More than one Early Head Start home visit, more than one Early Head Start case management meeting, at least two
weeks of center-based child development/child care, and/or Early Head Start group activities.
c
More than one Early Head Start home visit and/or at least two weeks of center-based child development/child care.
190
Levels of participation were higher in home-based and mixed-approach programs. Because
the two programs with the lowest participation rates (66 and 77 percent) were center-based,
center-based programs overall had the lowest participation rates. In one of these programs,
several factors contributed to these low rates, including some families’ need for full-time child
care before the program expanded to offer it, decisions to go to other programs that were more
convenient, and overwhelming life stress that interfered with families’ ability to take advantage
of program services.4 In the other, a very rapid initial recruiting process and a delay in opening
one center may have led some program families to make other child care arrangements.
Early, full program implementation appears to have promoted high participation rates.
Programs that were fully implemented by fall 1997 (the early implementers) involved 94 percent
of families in home visits and/or center-based services, compared with the 86 percent involved
by the later implementers and 78 percent by the incomplete implementers (Table IX.1).
2. Home Visits
All Early Head Start programs are required to visit families at home, whether they are
home-based, center-based, or mixed-approach. While in center-based programs,
services are delivered primarily in the center, and staff are required to visit children and
their families at home at least twice a year. They may meet with families in other places
if staff safety would be endangered or families prefer not to meet at home. Home
visitors are required to visit families receiving home-based services at home weekly, or
at least 48 times per year. In mixed-approach programs, some families receive home-
based services, some families receive center-based services, and some families may
receive a combination of center-based services and home visits.
Nearly all families enrolled in the home-based Early Head Start programs received more
than one home visit. In these programs, 92 percent of families reported receiving at least one
Early Head Start home visit, and 89 percent reported receiving more than one, which indicates at
4
Most center-based programs offered full-time care; however, this center initially offered
part-time care (later the program expanded to provide full-time care).
191
least minimal program participation (Table IX.2).5 Levels of receipt of more than one Early
Head Start home visit in the seven home-based research programs ranged from 84 percent to 95
percent (not shown).
Receipt of Early Head Start home visits remained high throughout the first two follow-up
periods but declined modestly in the second period as some families left the program.6 On
average, 70 percent of families reported receiving more than one Early Head Start home visit by
the time of the first followup. Reported home visit receipt declined to an average of 58 percent
of families during the second follow-up period (not shown).
As noted earlier, the research programs found it very challenging to complete the required
weekly home visits with many families. Among the home-based research programs, 57 percent
of families, on average, reported receiving Early Head Start home visits at least weekly during
the first follow-up period, and 52 percent reported Early Head Start home visits at least weekly
during the second follow-up period (Table IX.2). An additional one-fifth of families reported
receiving visits less than weekly but more than monthly, and 13 percent reported monthly or less
frequent visits (not shown). In contrast to this information from parent reports, the Early Head
Start programs reported that they increased home visit intensity to each family on average from
5
Those who reported one Early Head Start home visit may have been visited once as part of
the enrollment process to complete the application and enrollment forms, and they may never
have received any substantive services.
6
In summer 2000, program directors reported the last date on which they had contact with
each family. Approximately one-fourth of the program group members in the research sample
left the program within the first year after enrolling. See Section IX.D for a discussion of
families’ duration of participation.
192
TABLE IX.2
RECEIPT OF EARLY HEAD START HOME VISITS BY PROGRAM FAMILIES DURING THE FIRST 16 MONTHS,
FOR THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS
Average Percentage of Families Who Received
Among
Early Head Families Who
Early Head Start Home Received
Early Head Early Head Start Home Visits at Home Visits,
Start Home Start Home Visits at Least Percentage for
More than Visits at Least Visits at Least Least Monthly Whom Typical
Any Early One Early Weekly (1st Weekly (2nd Monthly (2nd Home Visit
Head Start Head Start Follow-Up Follow-Up (1st Follow- Follow-Up Lasted at Least Sample
Home Visits Home Visit Period) Period) Up Period) Period) One Hour Sizes
Full Sample 85 75 43 35 65 56 82 820–1,138
Program Approach in 1997
Center-based 64 34 4 1 16 12 62 108–232
193
Home-based 92 89 57 52 84 75 84 429–537
Mixed-approach 90 86 54 38 74 63 91 283–369
Pattern of Implementation
Early implementers 89 78 53 41 68 58 84 287–389
Later implementers 87 78 35 31 63 55 79 303–428
Incomplete implementers 77 67 42 31 62 54 84 219–319
SOURCE: Parent Services Follow-Up Interviews completed an average of 7 and 16 months after enrollment.
NOTE: The percentages are average percentages across programs in the group and are weighted for survey nonresponse.
two home visits a month in 1997 to three a month in 1999.7 These levels of completed home
visits are generally consistent with the experiences of other home-visiting programs, which have
found that on average, they are able to complete about half the intended number of home visits
(Gomby 1999).
The reported levels and intensity of completed home visits were very similar in the mixed-
approach programs, which provided home-based services to most families. In these programs,
86 percent of families received more than one Early Head Start home visit by the time of the
second followup. In addition, 54 percent of families, on average, reported receiving Early Head
Start home visits at least weekly during the first follow-up period, and 38 percent reported
receiving Early Head Start home visits at least weekly during the second (Table IX.2).
Most parents in home-based and mixed-approach programs who received Early Head Start
home visits reported that a typical visit lasted from one to two hours (Table IX.2). The reported
length of the typical visit did not change between the first and second follow-up periods.
Among the home-based and mixed-approach programs, earlier full implementation was
associated with providing home visits to a higher percentage of families and providing weekly
home visits to more families during the first two follow-up periods (Table IX.2). On average, in
the home-based and mixed-approach programs that reached early full implementation, 93 percent
of families reported receiving more than one Early Head Start home visit by the time of the
second followup, and 78 percent reported receiving Early Head Start home visits at least weekly
(not shown). In contrast, among later and incomplete implementers, 85 percent of families
7
The likely reason for this discrepancy is that programs reported on services for families that
continued to be engaged in the program, whereas the evaluation surveys tapped families that had
applied to Early Head Start, whether or not they continued to be enrolled or participate in
program activities.
194
reported receiving more than one Early Head Start home visit, and 46 percent of families
reported receiving Early Head Start home visits at least weekly.
3. Case Management
The revised Head Start Program Performance Standards require programs to work with
parents to obtain needed services and useful resources, and all the research programs
provide case management to link families with services and resources in the community.
In some home-based programs, the home visitors who work with parents and children on
child development also provide case management during home visits. In other home-
based programs, each family has two home visitors, one who works with them on child
development, the other on family development. In center-based programs, families may
work with a designated staff person on family development during meetings at the center
or at their home.
Home visits and case management services overlapped substantially. Most program families
reported receiving both home visits and case management (71 percent in the first follow-up
period and 56 percent in the second). More than 90 percent of these families reported that the
person they met with for case management was the same person who visited them at home.
Thus, not surprisingly, patterns of case management receipt mirror those of home visit receipt.
The average proportion of families who reported meeting with a case manager more than
once was highest in home-based and mixed-approach programs (83 percent, on average, by the
time of the second followup) and lowest in center-based programs (57 percent, on average, by
the time of the second followup) (Table IX.3). Similarly, receipt of weekly case management
was highest in the home-based programs and lowest in the center-based programs. Overall,
nearly half the families, on average, reported receiving case management at least weekly during
the first follow-up period, almost two-thirds at least monthly. Some programs, however, planned
case management meetings less often than weekly. Some home-based programs provided child
development services and case management in separate home visits, and case management
meetings were planned on a less frequent schedule, often biweekly. Center-based programs also
195
TABLE IX.3
RECEIPT OF EARLY HEAD START CASE MANAGEMENT BY PROGRAM FAMILIES DURING FIRST 16 MONTHS,
FOR THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS
Average Percentage of Families Who Received:
Early Head Early Head Start Early Head Start
More than Start Case Early Head Start Case Case
Any Early One Early Management Case Management Management Management
Head Start Head Start Meetings at Meetings at Least Meetings at Meetings at
Case Case Least Weekly Weekly (2nd Least Monthly Least Monthly
Management Management (1st Follow-Up Follow-Up (1st Follow-Up (2nd Follow-Up
Meetings Meeting Period) Period) Period) Period) Sample Sizes
Full Sample 81 77 44 34 65 52 1,067–1,137
Program Approach in 1997
Center-based 66 57 17 8 38 24 228–234
Home-based 85 83 56 45 77 61 496–535
Mixed-approach 83 49 38 70 60 343–368
196
Pattern of Implementation
Early implementer 86 82 55 42 66 60 357–390
Later implementers 74 70 33 26 62 41 407–428
Incomplete implementers 82 79 46 33 68 56 298–319
SOURCE: 87
Parent Services Follow-Up Interviews completed an average of 7 and 16 months after enrollment.
NOTE: The percentages are average percentages across programs in the group and are weighted for survey nonresponse.
planned case management meetings less frequently, and families in center-based programs, not
surprisingly, reported less-frequent receipt of case management.
Levels of case management receipt also tended to be highest, on average, in programs that
became fully implemented early. For example, in the early-implemented programs, 82 percent
of families, on average, received case management during their first 16 months in the program,
compared with 70 percent of families in later-implemented programs and 79 percent in programs
that were incomplete implementers (Table IX.3). The higher proportion among incomplete
implementers reflects the emphasis some of the programs in this group placed on family support.
4. Parenting Information Services and Group Parenting Activities
The Early Head Start program guidelines specified that programs must provide parent
education and parent-child activities. Consistent with their stated priority expected
outcomes, programs offered a variety of services that would potentially achieve these
outcomes.8 Most programs offering home-based services to some or all families invited
families to regular group activities at least once a month. (The revised Head Start
Program Performance Standards recommend two group socializations [parent-child
group activities] per month for programs offering home-based services.) In center-
based and mixed-approach programs, group parenting activities were more likely to be
parent education meetings.
Although most group activities for parents focus exclusively on parenting, some focus more
broadly. The interview excerpts in the following box show the increase over time in one parent’s
interest in attending group meetings at the KCMC Early Head Start program in Kansas City,
Missouri.
While most families (93 percent) received parenting information from Early Head Start,
often during home visits (85 percent) or in discussions with case managers (82 percent), fewer
received such information in Early Head Start group activities—parenting classes (45 percent),
8
As seen in Chapter III, most Early Head Start programs identified enhancing parent-child
relationships as a priority outcome.
197
group parent-child activities (25 percent), and/or parent support groups (10 percent). Overall,
slightly more than half of families, 53 percent on average, reported that they had attended any
type of Early Head Start group activity by the time of the second followup (Table IX.4).
Program approaches differed in how parenting education was delivered. Participation in
parenting classes or events was highest in center-based programs (51 percent in center-based
programs compared with 43 to 44 percent in other programs). As would be expected,
participation in parent-child group activities was highest in home-based and mixed-approach
programs (27 and 28 percent, respectively, compared with 17 percent in center-based programs).
Parents in home-based and mixed-approach programs also reported the highest levels of
receiving parenting information during home visits (93 and 90 percent, respectively), discussing
parenting with a case manager (90 and 86 percent), and receiving any parenting information
from the program (95 and 96 percent). Ten percent of families, on average, had participated in a
parent support group, with little variation across program approaches.
Success in implementing the performance standards was related to parent participation in
parenting and other group activities. The programs that were fully implemented early achieved
higher participation in any Early Head Start group activities than the later and incomplete
implementers (Table IX.4). By the time of the second followup, nearly two-thirds of families in
the early implementers had attended an Early Head Start group activity, compared with 44
percent of families in the later implementers and 52 percent in the incomplete implementers
(Table IX.4). Parents in programs that became fully implemented early reported the highest
levels of participation in all types of parenting education measured, compared with parents in the
later and incomplete implementers. These differences are greatest for participation in parenting
classes or events (56 percent in early implementers, compared with 34 and 45 percent in later
and incomplete implementers, respectively), although parents in the early-implemented programs
198
TABLE IX.4
RECEIPT OF PARENTING INFORMATION AND PARTICIPATION IN EARLY HEAD START PARENT EDUCATION AND OTHER GROUP
ACTIVITIES BY PROGRAM FAMILIES DURING THE FIRST 16 MONTHS, FOR THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS
Average Percentage of Parents Who:
Received Participated Participated
Any Participated in Any Early in Any Early Participated in Received
Parenting in Any Early Head Start Head Start Any Early Discussed Parenting
Information Head Start Parenting Parent-Child Head Start Parenting Information
from Early Group Class or Group Parent Support with a Case During Home Sample
Head Start Activitya Event Activity Group Manager Visits Sizes
Full Sample 93 53 45 25 10 82 85 1,118–1,136
Program Approach in 1997
Center-based 86 59 51 17 14 63 63 232–234
Home-based 95 51 43 27 7 90 93 524–537
Mixed-approach 96 52 42 28 10 86 90 362–365
199
Pattern of Implementation
Early implementers 97 64 56 29 11 82 89 384–388
Later implementers 92 44 34 25 8 82 86 420–429
Incomplete implementers 90 52 45 21 10 82 79 314–319
SOURCE: Parent Services Follow-Up Interviews completed an average of 7 and 16 months after enrollment.
NOTE: The percentages are average percentages across programs in the group and are weighted for survey nonresponse.
Encouraging Parent Group Participation: A Case Study
Kathy Thornburg, Jean Ispa, and Mark Fine
University of Missouri at Columbia
The following are excerpts from interviews that researchers at the University of Missouri at Columbia
conducted with Lakeisha over a one-year period. In Interviews 2 and 3, Lakeisha is not interested in going to
parent meetings, even if dinner and transportation are provided. By Interview 5, however, she is proudly attending
the parent meetings and explains to the interviewers how the group chooses a secretary to help mothers get involved
and feel connected.
Interview 2
Q. Were you invited to the parent group meeting a couple of weeks ago?
A. Yeah.
Q. Did you get to go?
A. I didn’t want to go.
Q. What were they doing?
A. They just had a dinner. It was two things that Sunday, they had a dinner, I don’t know if it was last month.
Q. Yeah, I came all the way from Columbia to that dinner. It was really very good. It was nice . . . and all the
babies came, it was so much fun. We held the babies.
A. I know.
Q. If they have a dinner the next time, you might want [to go]; they can even come pick you up.
A. I know, but I didn’t want to go.
Q. Well, do you want to go next time? Go with us. We’ll come get you, all the way from Columbia.
A. Well, you went to the last one.
Q. Well, if we come to town, we’ll for sure come get you. But they can come, they can provide transportation,
and Takiyah will go too. That was really fun. So, just think about going next time.
A. I probably had already ate and everything anyway.
Interview 3
Q. Okay, so you did get to go to one parent meeting?
A. Yeah, I went to one.
Q. What did they talk about?
A. Housing. They was talking about housing. All different kinds of stuff, you know.
Q. Do you think you’ll go to any more?
A. There’s one coming up. I think it’s next week . . . what is her name? I forgot her name, but she just came over
here the other day and she wanted me to come down, I mean to go to the other parent meeting. . . . She wanted
me to go to the other parent meeting. So I might go ahead and go.
Interview 5
Q. What about parents’ night? Have you gone?
A. Uh, yeah. We have one Saturday.
Q. Are you going?
A. Uh huh.
Q. Oh good. What’s the topic?
A. I’ve been going. I don’t know what the topic is this Saturday. We don’t know until we get there. But we have
different kind of people. Last time, I mean, we had this one guy that’s in our class, his mother, she’s an
entrepreneur, and she came to talk to us. You know, she’s a caterer, and all that. You know, she came and
talked to us at our last parent meeting. So, we’ve been having some good topics. You know, and they’re nice.
Q. How many Early Head Start moms are there usually?
A. Oh, it’s a lot of them. ’Cause see, it’s like they trying to get all the moms involved [and] being something.
Like, it’s a secretary. You know, it’s different, you know, it’s different people of those different things. So,
they trying to get everybody involved into something. You know, instead of us just sitting around listening to
’em, you know.
200
reported slightly higher rates of participation in any Early Head Start parent-child group activity
and receiving parenting information during home visits (see Table IX.4).
5. Child Care and Center-Based Child Development Services
Four of the research programs offered center-based child development services directly to
all enrolled families. In addition, two programs provided center-based services directly to a
substantial proportion of enrolled families, and four programs offered center-based child
development services directly to a small number of families by fall 1999. Many programs also
developed partnerships with community centers and family child care providers to provide good-
quality child care to Early Head Start children.
a. Child Care Use
Levels of child care use were high across all three program types, and child care use
increased over time as children got older. Two-thirds of children had received child care
services by the time of the first followup (not shown). By the time of the second followup, when
children were, on average, 20 months old, the percentage of program children who had received
child care services increased to nearly 80 percent (Table IX.5).
The proportion of families who had ever used any center-based child care increased over
time. One-third of all program children received care in child care centers during the first
follow-up period (not shown). By the time of the second followup, the percentage of children
who had been enrolled in center-based care increased to 43 percent (Table IX.5). The percentage
of children who received Early Head Start center-based care increased from 22 to 25 percent
(Table IX.5).
During the first two follow-up periods, many children received child care in more than one
arrangement, and sometimes they received care in multiple arrangements concurrently. On
201
TABLE IX.5
RECEIPT OF CHILD CARE DURING THE FIRST 16 MONTHS, FOR THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS
Average Percentage of Families Whose Child Was
In Any In the Following Number of In More
In Any Center- In Early Head Child Care Arrangements: Average than One
Child Based Child Start Center 3 or Number of Arrangement
Care Care Based Care 0 1 2 More Arrangements Concurrently Sample Sizes
Full Sample 79 43 25 21 34 25 21 2 34 1,063–1,097
Program Approach in 1997
Center-based 90 75 70 10 36 26 29 2 48 218–234
Home-based 72 25 0 28 31 23 19 1 29 492–525
Mixed-approach 80 42 24 20 36 26 19 2 32 353–365
Pattern of Implementation
Early implementers 82 49 35 18 34 27 21 2 38 370–387
202
Later implementers 75 39 24 25 30 22 22 2 34 367–420
Incomplete implementers 82 39 17 18 38 25 18 1 31 319–339
SOURCE: Parent Services Follow-Up Interviews conducted an average of 7 and 16 months after enrollment.
NOTE: Percentages are average percentages across programs in the given group and are weighted for survey nonresponse.
average, children received child care in two different arrangements (Table IX.5). One-third of
program children received care in multiple arrangements concurrently.
Program families used a wide range of providers for their primary child care arrangement
(the arrangement used for the most hours during the follow-up period) during the first 15 months
after enrollment.9 One-third of all program families used center-based care for their primary
child care arrangement—20 percent of families used an Early Head Start center and 14 percent
used other child care centers (Table IX.6). Another one-third of families relied on a relative—
most often a grandparent or great-grandparent—as their primary child care provider. Twelve
percent of families used a nonrelative child care provider as their primary child care
arrangement. Finally, 21 percent of families did not use any child care arrangements during the
first 15 months after enrollment.
A substantial proportion of children received some child care from their primary provider
during nonstandard work hours. Almost half the children received care from their primary child
care provider during early morning hours. Twenty-seven percent received care during evenings.
Smaller proportions received care during weekends and overnight (Table IX.6).
Families enrolled in the center-based programs were most likely to have used child care
during the first two follow-up periods (90 percent), followed by families enrolled in mixed-
approach programs (80 percent) and home-based programs (72 percent) (Table IX.5). Seventy
percent of the families in the center-based programs received Early Head Start center-based care.
9
The follow-up surveys collected detailed information on child care use during the follow-up
period, and it was possible to construct measures pertaining to the first 15 months of followup
for each sample member, even though the full length of followup varied. These measures are
more comparable across sample members than measures pertaining to the full follow-up period,
which varies in length across sample members.
203
TABLE IX.6
PRIMARY CHILD CARE ARRANGEMENTSa USED BY PROGRAM FAMILIES DURING FIRST 15 MONTHS, BY KEY PROGRAM
SUBGROUPS
Center- Mixed-
All Based Home-Based Approach Early Later Incomplete
Programs Programs Programs Programs Implementers Implementers Implementers
Percentage of children whose primary
arrangement was:
No child care arrangement 21 10 29 20 18 26 19
Head Start/Early Head Start 20 54 1 19 26 17 14
Child care center 14 6 17 14 13 12 16
Nonrelative 12 5 16 13 10 9 19
Parent or stepparent 8 5 11 7 10 6 8
Grandparent or great-grandparent 18 15 19 20 18 20 16
Another relative 6 4 7 7 4 9 6
204
Parent at school or work 1 0 1 0 1 0 1
Percentage of children whose primary
arrangement included care during:
Evenings 27 27 28 27 27 26 28
Early mornings 45 46 48 42 42 47 48
Weekends 16 13 17 16 14 14 20
Overnight 11 12 12 10 12 10 13
Sample Sizes 970–1,079 207–220 431–499 332–360 330–367 337–371 300–336
SOURCE: Parent Services Follow-Up Interviews conducted an average of 7 and 16 months after enrollment.
NOTE: Percentages are average percentages across programs in the group and are weighted for survey nonresponse.
a
The primary child care arrangement is the arrangement in which the focus child received care for the most hours during the follow-up period.
The remaining 20 percent of families who received child care received it from other sources and
did not use the Early Head Start center (Table IX.5). Many of these families are likely to be
those who had dropped out of Early Head Start by the time of the second follow-up interview
(but were still participating in the research).
In center-based programs, nearly half of children received care in concurrent arrangements
(Table IX.5). This suggests that Early Head Start centers did not provide child care during all
the hours that families needed care, and many families supplemented Early Head Start center
care with secondary arrangements.
Families in programs that were early implementers were more likely than families in other
programs to use center-based care and to use Early Head Start center-based care (Table IX.5).
This pattern of child care use reflects in part the fact that two out of the four center-based
programs—those with the highest participation rates—were early implementers.
b. Intensity of Child Care Use
Many program children received child care for substantial amounts of time during the first
15 months after enrollment. On average, children received child care for 16 hours a week. One-
third of program children were in child care for an average of 20 hours a week or more (Table
IX.7). About half of these children—15 percent overall—attended center-based care for at least
20 hours a week, on average, during the first 15 months. Twelve percent attended Early Head
Start centers for at least 20 hours a week, on average (Table IX.7).
Many program children were in child care arrangements during a large portion of the first 16
months after enrollment in Early Head Start. Approximately half the children received child care
for at least 60 percent of the combined follow-up period (Table IX.8).
205
TABLE IX.7
AVERAGE HOURS PER WEEK IN CHILD CARE DURING FIRST 15 MONTHS, BY PROGRAM APPROACH IN 1997
Center- Home- Mixed-
All Based Based Approach Early Later Incomplete
Programs Programs Programs Programs Implementers Implementers Implementers
Average hours per week in any child care 16 25 12 15 17 15 17
Percentage of children in any child care for:
0 hours per week, on average 22 10 29 21 19 27 19
1-9 hours per week, on average 28 21 31 30 29 29 28
10-19 hours per week on average 16 14 16 16 16 14 17
20-29 hours per week on average 16 19 13 16 15 15 18
30+ hours per week on average 18 36 10 17 22 15 18
Average hours per week in any center-based care 7 17 3 6 10 5 6
206
Percentage of children in any center-based child
care 63 27 81 66 55 67 68
0 hours per week on average
1-9 hours per week on average 13 19 8 14 15 12 11
10-19 hours per week on average 8 12 5 9 7 9 8
20-29 hours per week on average 7 18 4 5 8 7 7
30+ hours per week on average 8 24 1 6 15 5 6
Average hours per week in Early Head Start center-
based care 5 16 0 4 8 3 3
Percentage of children in any Early Head Start
center-based care
0 hours per week on average 77 32 100 79 67 79 85
1-9 hours per week on average 7 17 0 8 8 7 6
10-19 hours per week on average 5 11 0 6 4 6 3
20-29 hours per week on average 5 16 0 3 6 5 2
30+ hours per week on average 7 24 0 3 14 2 4
Sample Sizes 974–1071 193–225 396–499 273–347 335–365 343–405 298–324
SOURCE: Parent Services Follow-Up Interviews conducted an average of 7 and 16 months after enrollment.
NOTE: Percentages are average percentages across programs in the group and are weighted for survey nonresponse.
TABLE IX.8
PROPORTION OF THE FOLLOW-UP PERIOD THAT CHILDREN ATTENDED CHILD CARE DURING FIRST 16 MONTHS,
BY PROGRAM APPROACH IN 1997
Center-
Based Home-Based Mixed-Approach Early Later Incomplete
All Programs Programs Programs Programs Implementers Implementers Implementers
Percentage of Period in Any Child Care
0 percent 21 10 29 2 18 26 19
1-19 percent 3 2 3 5 4 4 2
20-39 percent 11 6 12 12 9 10 12
40-59 percent 13 9 14 14 13 14 11
60-79 percent 12 11 10 17 13 10 15
80-99 percent 19 30 13 18 22 17 18
100 percent 21 32 19 16 21 19 25
Percentage of Period in Any Center-
Based Care
207
0 percent 59 26 77 60 52 62 63
1-19 percent 3 3 3 5 4 4 2
20-39 percent 6 5 6 8 7 5 8
40-59 percent 7 10 5 8 7 9 6
60-79 percent 6 9 3 7 6 6 6
80-99 percent 11 25 5 7 13 9 9
100 percent 8 23 3 5 12 6 6
Percentage of Period in Early Head Start
Center-Based Care
0 percent 75 30 100 76 66 77 83
1-19 percent 2 3 0 2 2 1 0
20-39 percent 3 3 0 4 2 3 3
40-59 percent 4 11 0 5 5 5 2
60-79 percent 3 6 0 4 3 3 2
80-99 percent 7 24 0 5 11 6 4
100 percent 7 23 0 3 12 4 3
Sample Sizes 1,049–1,071 214–221 485–494 350–356 363–366 364–377 323–330
SOURCE: Parent Services Follow-Up Interviews conducted an average of 7 and 16 months after enrollment.
NOTE: Percentages are average percentages across programs in the group and are weighted for survey nonresponse.
As would be expected, children in center-based programs received more intensive child care
services, on average, than children in home-based or mixed-approach programs. Over half of
children in center-based programs received at least 20 hours of child care a week, on average,
compared with one-third of children in mixed-approach programs and slightly less than one-
quarter of children in home-based programs (Table IX.7). Nearly three-quarters of children in
center-based programs received child care for at least 60 percent of the follow-up period,
compared with half the children in mixed-approach programs and 42 percent in home-based
programs (Table IX.8).
Children in programs that were early implementers received more hours of center-based
child care and Early Head Start center-based care, on average, than children in other programs
(Table IX.7). They were also more likely to receive care for the entire 15 months after
enrollment (Table IX.8).
c. Child Care Costs
Three-fourths of families reported no out-of-pocket child care costs. Some families received
free child care from relatives or an Early Head Start center, and some families received child
care subsidies to cover the cost. One-quarter of all program families reported receiving a child
care subsidy for any arrangement during the first 15 months after enrollment (Table IX.9).
Eleven percent reported receiving a subsidy to pay for care in a center-based arrangement, and 6
percent reported receiving a subsidy for pay for care in an Early Head Start center.10
10
Approximately one-fifth of families in center-based programs who received Early Head
Start center care reported receiving a subsidy to help defray the costs of that care. Several Early
Head Start programs offering center-based care required that families eligible for state child care
subsidies apply for them. The families reporting subsidies for Early Head Start care were
probably families who were eligible and worked with the program to obtain child care subsidies.
208
TABLE IX.9
OUT-OF-POCKET CHILD CARE COSTS DURING FIRST 15 MONTHS,
BY KEY PROGRAM SUBGROUPS
Mixed-
All Center-Based Home-Based Approach Early Later Incomplete
Programs Programs Programs Programs Implementers Implementers Implementers
Average Weekly Out-Of-Pocket Child
Care Costs For:
Any child care arrangement $5.41 $4.87 $5.41 $5.77 $5.78 $5.14 $5.34
Head Start/Early Head Start program $0.54 $1.81 $0.00 $0.33 $0.60 $0.40 $0.00
Other child care center $3.31 $5.50 $2.23 $3.12 $4.02 $1.70 $2.79
Nonrelative provider $7.55 $9.37 $7.96 $5.86 $15.98 $4.01 $7.42
Parent or stepparent $0.06 $0.00 $0.15 $0.00 $0.00 $0.00 $0.18
Grandparent or great-grandparent $5.43 $13.28 $3.07 $2.97 $6.01 $3.57 $3.84
Other relative $3.22 $5.93 $3.19 $1.46 $3.29 $5.54 $2.82
Percentage of Families Who Received a
209
Subsidy To Pay For The Focus Child’s
Care in:
Any arrangement 26 20 32 22 28 21 29
A center-based arrangement 11 11 12 10 17 7 8
An Early Head Start center-based
arrangement 6 19 0 3 7 3 1
Sample Sizes 727–1,122 155–234 285–523 244–365 233–384 265–420 228–318
SOURCE: Parent Services Follow-Up Interviews conducted an average of 7 and 16 months after enrollment.
NOTE: Percentages are average percentages across programs in the group and are weighted for survey nonresponse.
On average, program families reported paying $5.41 per week out of pocket for child care
during the first 15 months after enrollment (Table IX.9). The variation in child care costs was
only slight across different types of programs.
6. Services for Children with Disabilities
According to the revised Head Start Program Performance Standards, at least 10 percent
of programs’ caseloads must consist of children with identified disabilities.
By the time of the second followup, 5 percent of program families reported that their child
had an identified disability (Table IX.10). The proportion of children with identified disabilities
ranged from 0 to 13 percent across programs (not shown). The parents’ reports of identified
disabilities may underreport them, however.11 It is also important to keep in mind that the
follow-up interviews were conducted over a fairly long period (because enrollment in the
research sample occurred over an approximately two-year period), during which the programs
also served nonresearch families; thus these percentages do not necessarily reflect the percentage
of children with identified disabilities served by the program at any given point in time.
Reported rates of identification of disabilities varied by program approach and degree of
implementation. On average, center-based programs had the highest proportion of children with
identified disabilities (6 percent), possibly as a result of increased opportunities for observing
children in center-based settings. Parents in fully implemented programs were only slightly
11
Parent-reported rates of identification of children with disabilities are substantially lower
than programs’ reports of children’s disability status. According to program staff, by summer
2000 (when most children had reached age 3) 13 percent of children, on average, had been
identified as eligible for early intervention services (ranging from 4 to 30 percent across
programs). Children were considerably older in summer 2000 than at the time of the second
followup, when they were, on average, only 20 months old, so it is likely that more children were
identified as they got older, and that the parent-reported proportion of identified children may
increase in later rounds of data collection. It is also possible that parents did not accurately
report their children’s disability status, in part because a variety of names are used across states
to refer to services for children with disabilities.
210
TABLE IX.10
RECEIPT OF SERVICES FOR CHILDREN WITH DISABILITIES DURING THE FIRST 16 MONTHS, FOR
THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS
Average Percentage of Families Whose:
Child Was Child’s Early
Eligible for Early Child Received Intervention Services
Intervention Early Intervention Were Coordinated with Sample
Services Services Early Head Start Sizes
Full Sample 5 3 2 1,091–1,109
Program Approach in 1997
Center-based 6 4 4 219–223
Home-based 5 4 3 514–520
Mixed-approach 3 2 1 358–366
Pattern of Implementation
Early implementers 5 4 3 372–380
Later implementers 5 3 3 387–389
Incomplete implementers 4 2 2 332–340
SOURCE: Parent Services Follow-Up Interviews conducted an average of 7 and 16 months after enrollment.
NOTE: Percentages are average percentages across programs in the given group and are weighted for survey
nonresponse.
a
Key services include home visits, case management meetings, center-based child development/child care services,
and/or group activities such as parenting classes or group socializations.
b
More than one Early Head Start home visit, more than one Early Head Start case management meeting, at least two
weeks of center-based child development/child care, and/or Early Head Start group activities.
c
More than one Early Head Start home visit and/or at least two weeks of center-based child development/child care.
211
more likely (5 percent) to report that their children had identified disabilities and received early
intervention services, but although the percentages are small, children in the early implementers
were twice as likely to have received intervention services (4 versus 2 percent) (Table IX.10).
Not all families who reported that their child had an identified disability had received early
intervention services by the time of the second followup, perhaps partly because of the time
required to set up services after identification. On average, 3 percent of families reported that
their child had received early intervention services. The percentage who reported receiving early
intervention services ranged from 0 to 8 percent across programs. Two percent of families
reported that their child’s early intervention services were being coordinated with the Early Head
Start program (Table IX.10), also ranging from 0 to 8 percent of families across programs.
7. Child Health Services
The revised Head Start Program Performance Standards require programs to ensure that
all children have a regular health care provider and access to needed health, dental, and
mental health services. Within 90 days of enrollment, programs must assess whether
each child has an ongoing source of continuous, accessible health care; obtain a
professional determination as to whether each child is up-to-date on preventive and
primary health care; and develop and implement a follow-up plan for any health
conditions identified.
All children had received some health services by the second followup (Table IX.11).
Nearly all children received some immunizations by the time of the second followup (97 percent
of all program children). More than 90 percent of children had visited a doctor. Program
families reported that 88 percent of children had visited a doctor for at least one checkup, and 71
percent had visited a doctor for treatment of an acute or chronic health problem (Table IX.11).
Differences by program approach or pattern of implementation were not great for most of the
health services, although children in the early-implemented programs had substantially higher
rates of visiting a doctor for illness or injury (85 percent, compared with two-thirds or less for
families in later-implemented and incompletely implemented programs). By the time of the
212
TABLE IX.11
RECEIPT OF CHILD HEALTH SERVICES BY PROGRAM FAMILIES DURING FIRST 16 MONTHS,
FOR THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS
Average Percentage of Focus Children Who:
Received Visited a
Any Visited a Doctor for Visited an Were
Health Visited a Doctor for Illness or Emergency Visited a Received Tested or Sample
Services Doctor a Checkup Injury Room Dentist Immunizations Screened Sizes
982–
Full Sample 100 92 88 71 42 11 97 55 1,110
Program Approach in 1997
Center-based 100 95 89 71 49 17 98 60 201–223
Home-based 100 93 89 68 42 11 96 53 463–521
Mixed-approach 100 89 85 74 38 8 98 55 318–366
213
Pattern of Implementation
Early implementers 100 97 92 85 47 12 99 53 372–381
Later implementers 99 86 81 66 34 10 96 51 385–390
Incomplete implementers 100 95 91 61 45 10 97 63 332–340
SOURCE: Parent Services Follow-Up Interviews completed an average of 7 and 16 months after enrollment.
NOTE: The percentages are average percentages across programs in the group and are weighted for survey nonresponse.
second followup, when children were 20 months old, on average, few children (11 percent) had
visited a dentist (Table IX.11). The low percentage of children receiving dental care reflects in
large part the fact that dental care and insurance providers often do not recommend dentist visits
before age 3. Slightly more children in early-implemented programs (12 percent) had visited a
dentist, compared to children in later-implemented and incompletely implemented programs (10
percent each). Although children in center-based programs were twice as likely to have visited a
dentist as children in mixed-approach programs (17 versus 8 percent) differences by
implementation pattern were small.
More than half of program children received at least one diagnostic or screening test, such as
a hearing test, lead test, or urinalysis (Table IX.11). Across programs, the proportion of children
who were tested or screened by the second followup varied widely, ranging from 37 to 78
percent (not shown). In center-based programs, 60 percent of children received testing or
screening, compared with 53 percent in home-based programs and 55 percent in mixed-approach
programs (Table IX.11). Interestingly, children in incompletely implemented programs were
more likely (63 percent) than early- (53 percent) or later-implemented programs (51 percent) to
complete testing or screening. One of those programs was housed in a health facility.
Many program children (42 percent) had visited an emergency room by the time of the
second followup (Table IX.11). Across programs, the proportion of children who had visited an
emergency room ranged from 22 to 66 percent (not shown). Nearly half of children in center-
based programs visited an emergency room, compared with 42 percent in home-based programs
and 38 percent in mixed-approach programs (Table IX.11). More children in early-implemented
programs visited an emergency room (47 percent), compared to later-implemented (34 percent)
and incompletely implemented programs (45 percent).
214
8. Family Health Services
The Head Start Program Performance Standards require programs to develop family
partnerships and work collaboratively with families to identify and continually access,
either directly or by referral, community services and resources that respond to the
families’ needs and goals. These include services to meet families’ physical and mental
health care needs and goals.
Nearly all families (98 percent) received some health services by the time of the second
followup (Table IX.12). The proportion of families who received any health services ranged
from 85 to 100 percent across programs (not shown), but did not differ very much for families in
different types of programs or in programs with different implementation patterns.
At least one family member in 68 percent of families had visited a dentist by the time of the
second followup. Similarly, at least one family member in nearly two-thirds of program families
visited an emergency room by the second followup (Table IX.12). Families in center- and home-
based programs were somewhat more likely than families in mixed-approach programs to have
had a family member visit a dentist. More families visited a dentist in early-implemented
programs than in later-implemented or incompletely implemented programs.
Fewer families reported receiving mental health services. By the time of the second
followup, 16 percent of families reported that at least one family member had received treatment
for an emotional or mental health problem, and 3 percent reported that at least one family
member had received drug or alcohol treatment (Table IX.12). Early-implemented programs led
in families’ receipt of mental health services over later-implemented and incompletely
implemented programs.
9. Other Family Development Services
As noted in the last section, the Head Start Program Performance Standards require
programs to form partnerships with families and provide or link them with community
services and resources that will help them meet their goals. The performance standards
specifically direct programs to help parents identify and access, either directly or by
referral, education- and employment-related programs and resources.
215
TABLE IX.12
RECEIPT OF FAMILY HEALTH SERVICES BY PROGRAM FAMILIES DURING FIRST 16 MONTHS,
FOR THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS
Average Percentage of Families With at Least One Member Who:
Received
Received Visited an Treatment for an Received Drug Received Any
Any Health Visited a Visited a Emergency Emotional or or Alcohol Mental Health
Services Doctor Dentist Room Mental Problem Treatment Services Sample Sizes
Full Sample 98 96 68 62 16 3 17 1,014–1,111
Program Approach in 1997
Center-based 99 98 71 67 15 1 16 203–224
Home-based 97 96 73 61 17 5 20 480–521
Mixed-approach 98 96 60 60 14 4 16 331–366
216
Pattern of Implementation
Early implementers 99 98 73 68 22 4 24 374–384
Later implementers 96 93 62 56 11 3 13 329–390
Incomplete implementers 99 98 70 61 14 3 15 328–340
SOURCE: Parent Services Follow-Up Interviews completed an average of 7 and 16 months after enrollment.
NOTE: The percentages are average percentages across programs in the group and are weighted for survey nonresponse.
Most primary caregivers (83 percent) reported receiving education-related services by the
time of the second followup (Table IX.13). Two-thirds of primary caregivers reported talking to
a case manager about education services, and slightly more than half reported attending school or
a job training program (Table IX.13). The proportion of families who reported talking to a case
manager about education was substantially higher in home-based and mixed-approach programs
(73 percent) than in center-based programs (47 percent) (Table IX.13).
Two-thirds of program families reported receiving some employment-related services by the
time of the second followup (Table IX.13). Twenty-two percent of families reported receiving
job search assistance by the second followup, and 61 percent of families reported talking to a
case manager about finding a job or job training (Table IX.13). Two-thirds of families in home-
based and mixed-approach programs reported talking to a case manager about employment,
compared with 44 percent in center-based programs (Table IX.13).
Families enrolled in programs that were incomplete implementers were most likely to receive
education- and employment-related services by the time of the second followup. Eighty-eight
percent received education services (talked to a case manager about education and/or attended an
education or training program), and 73 percent received employment-related services (talked to a
case manager about finding a job or received job search assistance). Families enrolled in the
programs that were early implementers received slightly lower levels of education- and
employment-related services (Table IX.13). The high levels of service receipt in these areas in
the incomplete implementers reflects the strong emphasis that some programs in this group
placed on family support.
Many families received other family support services. Nearly 30 percent of program
families received transportation assistance (Table IX.13). More families in mixed-approach and
home-based programs than in center-based programs received transportation assistance. Half of
217
TABLE IX.13
RECEIPT OF EDUCATION, EMPLOYMENT, AND TRANSPORTATION SERVICES BY PROGRAM FAMILIES DURING
THE FIRST 16 MONTHS, FOR THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS
Average Percentage of Families Who:
Received Discussed Received Any Discussed
Any Attended Education Employment- Received Job Finding a Job Received Any
Education School or with a Case Related Search with a Case Transportation
Services Job Training Manager Services Assistance Manager Assistance Sample Sizes
Full Sample 83 52 67 68 22 61 29 818–1,111
Program Approach in 1997
Center-based 77 56 47 55 21 44 22 160–224
Home-based 83 48 73 71 25 66 30 393–521
Mixed-approach 85 54 73 72 19 67 32 265–366
218
Pattern of Implementation
Early implementers 84 51 67 68 21 63 28 379–381
Later implementers 77 46 63 62 19 57 31 387–390
Incomplete implementers 88 59 71 73 27 64 27 338–340
SOURCE: Parent Services Follow-Up Interviews completed an average of 7 and 16 months after enrollment.
NOTE: The percentages are average percentages across programs in the group and are weighted for survey nonresponse.
program families received housing assistance (public housing, rent subsidy, help finding
housing, and/or energy assistance) by the time of the second followup (Table IX.14). Families in
home-based programs were more likely to receive any housing assistance, help finding housing,
emergency housing, and energy assistance, but families in center-based programs were more
likely to receive assistance with public housing or with rent subsidies. Receipt of housing
assistance, especially receipt of public housing or rent subsidies, was higher among families in
incompletely implemented programs, which might reflect the greater emphasis on family support
in these programs or greater needs for housing assistance in the areas served by the incompletely
implemented programs.
C. ENGAGEMENT IN SERVICES
To achieve their goals and influence child and family outcomes, Early Head Start programs
must engage families in program services and activities (that is, they must gain the parent’s and
child’s attention and involve them actively in program activities) and continue engaging them
over time. The extent to which children and families benefit from Early Head Start participation
is likely to depend in part on the quality and duration of their involvement in program services
and activities during their enrollment.
In addition to asking parents about their participation in Early Head Start and other services
and activities, we asked program staff in summer 2000 to rate each family’s engagement in the
program during the time they were enrolled. Staff members were asked to use the following
ratings for each family:
• Consistent High Engagement: The family was consistently highly engaged in the
program throughout its enrollment—the family kept most appointments, was actively
engaged in home visits and group activities, and (when applicable) the child attended
the center regularly.
219
TABLE IX.14
RECEIPT OF HOUSING ASSISTANCE BY PROGRAM FAMILIES DURING THE FIRST 16 MONTHS, FOR THE FULL
SAMPLE AND KEY PROGRAM SUBGROUPS
Average Percentage of Families Who Received:
Any Housing Public Housing or Help Finding
Assistance Rent Subsidy Housing Energy Assistance Emergency Housing Sample Sizes
Full Sample 50 31 17 17 3 1,013–1,109
Program Approach in 1997
Center-based 49 37 14 13 1 205–224
Home-based 56 31 20 22 4 477–520
Mixed-approach 45 28 17 13 3 331–365
Pattern of Implementation
Early implementers 52 27 17 22 5 374–380
220
Later implementers 40 26 15 11 2 379–389
Incomplete implementers 62 43 21 17 3 326–340
SOURCE: Parent Services Follow-Up Interviews completed an average of 7 and 16 months after enrollment.
NOTE: The percentages are average percentages across programs in the group and are weighted for survey nonresponse.
• Variable Engagement: The family’s engagement varied during its enrollment—the
family was sometimes highly engaged in the program, and at other times, the family’s
engagement was low.
• Consistent Low Engagement: The family’s engagement in the program was
consistently low throughout its enrollment—the family kept some appointments but
missed and canceled frequently, did not engage actively in home visits and group
activities, and (when applicable) the child was often absent from the center.
• No Engagement: The family was not engaged in the program at all.
• Can’t Remember: Staff could not remember how engaged the family was.
Staff provided the ratings in summer 2000, when more than 80 percent of the research
families had left the program because their child turned 3 years old or for other reasons (the
remaining families were still engaged in the program).12 Thus, the ratings pertain to a longer
period than is covered by the first two parent services follow-up interviews. Sixteen of the 17
research programs provided ratings for their research families.
The engagement ratings provided by program staff show that on average, slightly more than
one-third of the research families became highly engaged in program services (Table IX.15).
Consistent with the families’ reports of their program participation, the staff reported that only 7
percent of families, on average, did not become engaged in the program at all.
The extent to which program staff rated families as highly engaged varied substantially
across sites, however, ranging from 20 to 74 percent (not shown). The staffs of three programs
reported that at least half the research families enrolled in their program were highly engaged.
Center-based programs were more likely than home-based or mixed-approach programs to
report that families were highly engaged. Center-based programs reported that 47 percent of
families, on average, were highly engaged in Early Head Start throughout their enrollment. In
12
Staff rated all families who had ever been enrolled even though some families had left the
program at the time of the ratings.
221
TABLE IX.15
STAFF RATINGS OF PROGRAM ENGAGEMENT, FOR THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS
Average Percentage of Families Who Were Rated As:
Consistently
Consistently Engaged at Varying Engaged at a Low Not Engaged at Could Not
Highly Engaged Levels over Time Level All Remember Sample Sizes
Full Sample 37 32 18 7 6 1,408
Program Approach in 1997
Center-based 47 32 7 5 8 306
Home-based 39 29 24 8 10 603
Mixed-approach 38 32 20 8 3 499
Pattern of Implementation
Early implementers 44 29 19 8 1 521
Later implementers 31 38 17 7 6 528
222
Incomplete implementers 37 27 15 7 14 457
SOURCE: Ratings of program engagement provided by program staff in summer 2000.
NOTE: The percentages are average percentages across programs in the group.
contrast, 39 percent of families, on average, in home-based (and 38 percent in mixed-approach)
programs were reported to have been consistently highly engaged (Table IX.15).
Early full implementation is associated with higher levels of program engagement. The
early-implemented programs reported that a higher proportion of families became highly
engaged in the program (44 percent, on average). The later-implemented programs reported the
smallest percentage of families, on average, as highly engaged (31 percent) (Table IX.15).
The engagement ratings provided by program staff are generally consistent with the information
families provided in the first two parent services follow-up interviews. Nearly all families (93
percent) who reported receiving more than minimal Early Head Start services (more than one
home visit, more than one case management meeting, center-based child development services,
and/or group activities) during the first two follow-up periods were rated by program staff to
have had low, variable, or high program engagement. Staff members were unable to rate the
engagement of 4 percent of these families, probably because the staff members who worked with
them were no longer employed by the program.13
The duration of families’ participation in the program also varied. According to program
records, among the research families who had left the program, approximately half participated
for at least two years, and half participated for less time. In 3 of the 16 programs (one center-
based, one home-based, and one mixed-approach), nearly two-thirds of the research families
participated for at least two years. In contrast, in three other programs, only slightly more than
13
A few families (1 percent) did not report receiving more than minimal Early Head Start
services during the first two follow-up periods, but were rated by program staff as highly
involved. An additional 2 percent of families did not report receiving more than minimal Early
Head Start services in the first two parent services follow-up interviews, but were rated by
program staff as having variable engagement in the program. These families may have become
more involved in the program later, but may also have underreported Early Head Start services in
the interviews.
223
one-third of the research families participated for at least two years. A higher proportion of
families were enrolled for at least two years in the mixed-approach programs (61 percent) than in
the home-based and center-based programs (47 percent).
Research families left the programs for a variety of reasons. Of the families who had left
when staff rated their engagement, approximately one-third had graduated or transitioned out of
the program and one-fourth moved before completing the program. Nearly one-third of the
families either were terminated by staff because of poor attendance or lack of cooperation or
asked to be removed from the program rolls. Families’ reasons for leaving were similar among
the home-based, center-based, and mixed-approach programs, except that home-based programs
were much more likely to report that they terminated families’ enrollment for poor attendance or
lack of cooperation, while other types of programs were more likely to report that families asked
to be removed from the program rolls.
1. Local Research on Program Engagement
Several researchers working in partnership with Early Head Start research programs have
studied families’ engagement in program services. In three boxes, we see examples of local
research studies that have delved more deeply into understanding levels of engagement and
exploring the nature of program engagement. In the first box, Paul Spicer of the University of
Colorado describes the meaning of participation in the Early Head Start program at Family Star
in Denver. Using ethnographic research methods, he describes how parents attributed changes in
their children to their participation in Family Star, a center-based program. This in turn led
parents to become more engaged with the program and to implement elements of program
practices at home.
Maggie McKenna, a research partner of the Families First Early Head Start program in
Kent, Washington, has also conducted ethnographic research to better understand program
224
engagement. In the next box, she describes home visits with one family and what these home
visits meant to this family. This example shows that for some families, what appears to be a low
level of family engagement may in fact be very meaningful for the family.
In the third box, Beth Green and Carol McAllister, researchers working with the University
of Pittsburgh Early Head Start program, use a combination of quantitative and qualitative
methods to understand the reasons that some families have low levels of participation.
2. Family Risk Factors and Program Participation
Some programs’ local research partners have worked with program staff to understand
family risk factors that may interfere with families’ participation in Early Head Start. In the
following box, the University of Kansas researchers who are working with the Project EAGLE
Early Head Start in Kansas City, Kansas, describe the risk factors they have identified.
D. THE MATCH BETWEEN FAMILIES’ EARLY NEEDS AND SERVICE USE IN
SPECIFIC AREAS
Identifying and articulating needs and goals often requires getting to know families over
time and developing relationships with them. Interactions with staff members over time may
also lead families to recognize needs that they did not perceive at the time they enrolled. Needs
also change. For this study, we obtained “snapshots” of families’ needs at the time they enrolled
in Early Head Start (as part of the application and enrollment process with staff) and when they
completed the follow-up parent services interviews approximately 7 and 16 months after
enrollment. Care must be taken in interpreting the information below on families’ levels of need,
especially in sensitive areas such as social support, for two reasons: (1) these survey-based
snapshots may miss frequent changes in family situations; and (2) some families may not have
revealed all their needs, particularly at the time of enrollment.
225
Ethnographic Perspectives on Engagement at Family Star Early Head Start
Paul Spicer
University of Colorado Health Sciences Center
The Early Head Start program at Family Star built upon the program’s established commitment to Montessori
early childhood education for children aged 0 to 5. Full-day child development services for Early Head Start
children were provided in eight classrooms: two infant environments, five toddler environments, and a Bridge
classroom designed to expose older children to more advanced Montessori materials. Family Star also provided a
comprehensive set of health and family services, including a substantial commitment to mental health services for
children and families, in addition to a monthly educational parent night. At the center of the program’s model,
though, was a commitment to change families by changing their children; the ethnographic research was designed to
examine the extent to which the program was able to accomplish these ends.
Following a year of participant-observation in the program’s classrooms, 12 families were recruited into the
home visit component of the ethnographic research. These families were selected only if their children had
participated in the program over their first year of enrollment. Thus, this research cannot address the meaning of the
program for those families who withdrew during their first year of program enrollment. While we have alternative
sources of information for these families (such as program reports on reasons for withdrawal), we focus here on the
meaning of the intervention for families whose children regularly attended the program. With only one exception,
the 12 families that participated in this intensive ethnographic work remained enrolled in the program until their
children turned 3 and moved on to other settings.
The ethnographic study design involved three visits to participating families’ homes over the course of their
child’s second year in the program. These visits began when the family had been in the program for one year, with
two additional visits at six-month intervals after that. In all cases, mother and child participated, but if fathers were
involved in the lives of their children, every effort was also made to include them. The focus of conversation during
these visits was on the meaning of the program to the family, especially the changes in their children that they
attributed to the program and the ways in which they were attempting to use elements of program philosophy in their
own parenting.
This ethnographic work underscored the value that these families placed on the program approach. All parents
emphasized positive aspects of their children’s development that they attributed to the program, especially the
independence that their children demonstrated and the pace of their children’s developing interest in and
engagement with the world around them. Many of these parents pointed to how much more advanced their child
seemed to be compared to their other children at the same age or other children in their families and neighborhoods.
Seeing their children develop in these ways often made these parents quite ardent advocates for the program’s
philosophy, and all of them had tried to incorporate elements of the program’s classroom design in their homes (for
example, by keeping their children’s toys in a place where they could get them on their own or by setting up a small
table and chair at which the child could work and/or eat). They also made efforts to reinforce classroom behavior
that the child brought to the home (for example, cleaning up after play or after a meal).
The experience of this group of parents at Family Star underscores the potential effectiveness of their program
model, which held that it would be possible to reach parents through their children. Our ethnographic work on the
reception of the program—its meaning and value to participating families—emphasizes that this program’s approach
has the potential to powerfully impress parents and to instill in them a commitment to learning how to amplify these
program effects in their own homes.
226
RELUCTANT HOME VISIT IS A MAJOR ACCOMPLISHMENT FOR PARENT
Maggie McKenna
University of Washington
The Child Development home visitor’s repeated requests to schedule a home visit with a 19-year-old mother
would be met with the mother’s unenthusiastic “O.K.” The home visitor drove weekly to an apartment complex of
three-story buildings where children stood in the parking lot kicking rocks and stopped to look at any car that drove
into the lot and infringed on their play area. The home visitor would walk up a flight of stairs covered with torn
indoor/outdoor carpet toward a second-story apartment. The home visitor’s loud knocks at the mother’s apartment
door were met by the mother, who wordlessly motioned to the home visitor to enter. The home visitor sat on the
floor in a living room furnished only with one tired old plaid-upholstered sofa. The 4-month-old infant was in an
infant carrier placed on the floor, out of the mother’s touch, but the mother could see her son as she sat on the sofa.
The home visitor talked to the young mother about the child’s eating patterns and usual daily activity. The
home visitor’s eager questions about the child’s wiggling fingers and reaching for a bottle were met by the mother’s
reply that she fed the infant as quickly as possible and discouraged the child from reaching or grasping. This reply
and what the home visitor assessed as a lack of tactile stimulation for the infant prompted the home visitor to
encourage the mother to hold the child and stimulate the infant’s motor development. The mother did slowly
demonstrate the touches and gentle positioning shown by the home visitor, but did not talk to the home visitor of
feeling more at ease with the infant. The home visitor’s continued weekly visits always met with the mother’s very
brief verbal responses.
When the mother announced that she was moving to be near relatives in another state, she agreed to a closing
interview with another person from the program staff. The interviewer met the mother, and they sat and talked for
an hour on the stairs outside the apartment, watching and listening to older children playing in the parking lot. This
mother who had responded only with one-word replies on weekly visits stated that she had actually looked forward
to the visits. The mother looked up and smiled as she said the home visitor had been the only person who ever
listened to what she said, who had provided her with information, and who asked her how she was and showed
patience to hear the mother’s reply. The mother replied, “She [the home visitor] talked to me. My boyfriend never
does that. She supported me, and she acted like she had all the time in the world to be here.” The mother
volunteered that she appreciated how the home visitor showed her to hold and feed her son. The parent did not
know how to express to the home visitor that she had learned more in their time together than she could recall ever
spending with anyone else.
The mother’s hesitation and nonverbal behavior that the home visitor struggled to assess were really the result
of the young mother not having any social experience or previous interactions that prepared her to receive a friendly
and knowledgeable visitor into her home. In separate interviews, the Program Staff learned that the mother had
grown up in relatives’ homes and in foster families and that her memories were of moving to another place
whenever she was too much to care for. She did not recall any person as influencing her or helping her as a child.
The relationship-building time invested by the home visitor had brought a sense of confidence to the parent she had
never experienced before. The home visits were the only meaningful interaction that the mother had experienced
and helped her to interact more appropriately with her own son to break the cycle and prevent a recurrence of
detached, withdrawn parenting in another generation.
227
Which Families Are Engaged, and Why?
Beth L. Green and Carol McAllister
NPC Research, Inc., and University of Pittsburgh
Researchers and practitioners in the Pittsburgh Early Head Start program have been working to understand the
factors associated with families’ participation in program services. Although Early Head Start services are designed
to be comprehensive and intensive, delivered over a three-year time span, many families leave the program before
they have received many services and are difficult to engage actively. Using both quantitative and qualitative
methods, we investigated reasons for low participation in services and examined family and contextual
characteristics that may be related to program engagement.
Following training provided by the research team, two sets of program staff rated each family (n=101) on
scales measuring engagement in program services. Staff rated each family in terms of their (1) ease of engagement
in services (easy, difficult, or very difficult to engage); and (2) level of engagement (never, somewhat, or very
involved). Correlations between ratings made by the two different groups of staff were high (ranging from r=.67 to
r=.93), so ratings were averaged for final analysis.
Families’ ratings were then correlated with a number of measures collected through a baseline interview.
These interviews were collected within 60 days of program enrollment, and included measures of social support,
self-efficacy, depression, coping style, sense of cultural identity, and relationship with the child’s father. Eight
families and the Early Head Start program staff that they work with were also given open-ended, qualitative
interviews to explore in greater depth issues regarding participation and family needs.
Results indicated that families tended to be either easy to engage (49%) and very involved (39%) or difficult to
engage (32%) and never involved (35%). Further, a large percentage of families (44%) remained in the program for
less than one year; in fact, the program dropped 27 percent of the families because of a lack of participation.
Clearly, participation was a significant problem for a substantial number of families.
We examined correlations between engagement ratings and the parent reports from the baseline interviews.
Results indicated that families who were easier to engage tended to be less able to afford things for their families
(r=.29). However, they also showed a more positive coping style (r=.21) and sense of cultural identity (r=.32), were
higher in social support (r=.33), and were more likely to have an involved father figure (r=.27) (all correlations
significant, p<.05).
Qualitative interviews suggested that engaged families entered the program with a clear sense of their goals
and a better ability to seek out support when needed. Staff also identified a group of parents who entered the
program with concrete needs and were engaged initially, but became less engaged over time. Staff identified two
key reasons for a lack of family engagement, including (1) a lack of time, usually related to work and school
schedules (especially since the onset of welfare reform); and (2) a lack of social/emotional resources to establish
relationships with program staff and other families.
Results of both quantitative and qualitative data collection suggest that “easy to engage” families are those who
enter with more social/emotional resources, such as existing social support networks, positive coping skills, and the
ability to seek help when needed. Further, it is clear that there is a significant subgroup of parents who are difficult
to engage and at high risk for dropping out of program services. These parents appear to enter the program with
different social/emotional characteristics, compared to highly engaged parents. Clearly, it is important for both
researchers and practitioners to continue to try to understand more about the reasons that families participate or not,
and how varying levels of participation and engagement may influence program outcomes.
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Family Risk Factors and Participation in Early Head Start
Jean Ann Summers, Jane Atwater, and Judith Carta
University of Kansas
A study completed by the Kansas Research Partners identified types of risk factors that appear to impede
parents’ ability to participate fully in Early Head Start programs.1 Researchers observed case conferences in the
Project EAGLE Early Head Start program from May through July of 1998. At that time, Project EAGLE served
families primarily in home visits, and supervision consisted in part of weekly case conferences with each home
visitor to discuss each family in her caseload.2 The primary purpose of each case conference was to identify
emerging problem areas for the family and to brainstorm possible resources or actions to address the issues. As a
result, the case conferences did not focus on family strengths or general characteristics, nor did they provide a
summary of all interventions provided to each family, since those that were going well were not discussed. The case
conferences provided, however, an opportunity to learn more about the risk factors program staff perceived as
interfering with the family’s abilities to reach their goals and engage in the program’s parenting curriculum. Risk
factors discussed in these conferences fell into two categories: (1) self-sufficiency issues, and (2) mental health and
socio-emotional issues.
Of the 128 self-sufficiency issues or needs that were mentioned in case conferences for 73 families, 25 percent
involved a need or goal to move off TANF assistance, and 22 percent involved a need for employment. Training
needs or goals were discussed for 20 percent of the families. Other issues or needs discussed included no
transportation (19%), inadequate housing (15%), poor budgeting skills (5%), and legal problems (10%).
Project EAGLE staff had previously identified nine family characteristics or risk factor categories that they
used to design assessments and interventions. During the case conferences for 73 families, references to these risk
factors occurred 210 times. These included mental health issues (21%); age/maturity issues (7%); family conflict or
support issues (14%); cognitive level issues (5%); problems with physical appearance (4%); parent health issues
(14%); and social behavior issues (for example, motivation level, problem-solving skills, and social skills) (12%).
A total of 59 mental health issues were discussed for 44 families. These involved depression (19%); substance
abuse (25%); domestic violence (31%); socio-emotional problems, such as anger control (8%), self-esteem (3%),
and other specific mental health diagnoses (including bipolar, manic-depressive, grief issues, and suicidal
tendencies) (14%). In addition, specific issues related to poor problem-solving or coping skills were discussed for
23 families. These included poor follow-through on planned actions (17%), poor planning and organizational skills
(17%), low motivation or expectations (13%), impulsivity (13%), resistance to the program (13%), passivity (9%),
poor short-term memory (9%), poor social skills (4%), and actively engaged in denial (4%).
Some families had fewer risk factors than others. Because Early Head Start serves low-income families, the
self-sufficiency risk factors were fairly common among the families. With respect to the nine more-intangible risk
factors, the number mentioned in case conferences ranged from none (for seven families) to seven identified issues
(for two families). The mean number of risk factors was 0.97. The modal number of risk factors was 2 and 3, with
18 families identified with 2 and 3 factors, respectively.
_____________
1
Summers, J. A., Atwater, J. E., and Carta, J. C. (1999). “Issues and Characteristics of Families Served in an
Early Head Start Program.” University of Kansas Juniper Gardens Children’s Program, Early Head Start Research
Project Working Paper No. 1.
2
Case conferences lasted approximately three hours each week and involved between 8 and 12 families in each
session. The Local Researchers attended 12 conferences, involving 8 program Advocates. The total unduplicated
number of active cases reviewed in these conferences was 73. Transcripts of the case conferences were analyzed
using a coding sheet covering the primary research questions for the study, which included, among others, a tally of
types of risk factors or issues mentioned in each of the program areas.
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1. Summary of Needs
When they enrolled, families were most likely to report having needs in the areas of education
and employment.14 Slightly more than half the families indicated that the job they or their
partner had was inadequate or that they were unemployed and thus had needs for education or
employment (Table IX.16). Similarly, slightly more than half the families reported that they did
not have a high school diploma or GED, or that they had limited English-speaking skills. For
these caregivers, improving English-speaking skills and completing more education may have
been important for increasing their employment opportunities and for helping them gain access
to other services they needed.
For many families, the needs expressed when they enrolled also included child care, family
health care, and transportation. Approximately one-third of the families reported that the
babysitting or child care for their children was inadequate or an urgent need (Table IX.16). For
most families, obtaining child care is essential for enabling parents to participate in education
programs or go to work. While some families have family members or relatives who can
provide child care while primary caregivers work or go to school, many do not.15
All the families who enrolled in the Early Head Start research programs had health care
needs—all of them included a pregnant woman or had infants who needed regular well-child
examinations, immunizations, and screening tests. When they enrolled, nearly 30 percent
reported that their health care was inadequate to meet their needs or that it was an urgent need
(Table IX.16).
14
Many of the study families enrolled in Early Head Start around the time new welfare rules
were being implemented. These new rules included work requirements as a condition for
receiving cash assistance, as well as lifetime time limits on cash assistance. For many, the early
months of program participation were a time when families and staff were learning about the
new rules and exploring ways to meet the requirements and work toward self-sufficiency.
15
At the time of enrollment, about one-fourth of the applicants were pregnant.
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TABLE IX.16
SELECTED NEEDS REPORTED BY PROGRAM FAMILIES AT BASELINE,
FOR THE FULL SAMPLE AND KEY PROGRAM SUBGROUPS
Average Percentage of Families Who Reported a Need for:
Services for
Children Family Housing
Parenting With Child Health or Sample
Information Disabilities Care Education Employment Care Utilities Transportation Sizes
Full Sample 13 8 35 53 53 29 14 25 872–1,039
Program Approach in 1997
Center-based 6 7 51 47 50 28 11 20 204–221
Home-based 15 8 24 55 53 29 14 25 313–482
231
Mixed-approach 14 7 37 56 55 31 16 29 275–336
Pattern of Implementation
Early implementers 8 7 36 44 46 32 13 23 312–362
Later implementers 17 7 29 67 55 32 13 27 344–406
Incomplete implementers 13 9 39 50 58 20 17 26 247–295
SOURCE: Parent Services Follow-Up Interviews completed an average of 7 and 16 months after enrollment.
NOTE: The percentages are average percentages across programs in the group and are weighted for survey nonresponse.
Having a reliable means of transportation is essential for obtaining and maintaining
employment, taking family members to health care appointments, attending Early Head Start
program activities, and gaining access to other important services and opportunities. When they
enrolled, one-quarter of all families reported that their transportation was inadequate or an urgent
need (Table IX.16).
Social support from family, friends, and community members is also important to the
success of low-income families who are striving toward self-sufficiency and effective parenting.
Nine percent of primary caregivers indicated that the availability of someone to talk to was
inadequate or an urgent need, 19 percent reported that their opportunities to participate in
community groups were inadequate or an urgent need, and 13 percent reported that the
availability of friends or family to help them was inadequate or an urgent need. Altogether,
nearly one-third of the primary caregivers who enrolled in Early Head Start with their children
expressed a social support need when they enrolled (not shown).
Fewer families expressed needs in other key areas. For example, 14 percent reported that
their housing or utilities were inadequate, and 13 percent reported that their information or
access to information about parenting was inadequate (Table IX.16).
Families’ reported needs at enrollment generally did not differ substantially by program
approach or implementation pattern. One exception, however, is that families who enrolled in
the center-based programs were much more likely to express a need for child care (51 percent,
compared with 24 and 37 percent in home-based and mixed-approach programs, respectively)
(Table IX.16). Families enrolling in center-based programs and programs that were
implemented early were also less likely to report a need for parenting information or access to
parenting information (for example, 6 percent of center-based programs compared with 14 to 15
percent in the other types of programs).
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2. Match Between Needs and Services
To assess the extent to which the services families received during their first 16 months of
enrollment met the needs they expressed at the beginning or their enrollment, we divided
families into four groups for assessing each key potential area of need:
1. Those who reported a need at baseline and received a service in that need area during
the follow-up period
2. Those who reported a need at baseline and did not receive a service in that area
during the follow-up period
3. Those who reported no need at baseline but received a service in that area during the
follow-up period
4. Those who reported no need at baseline and did not receive a service in that area
during the follow-up period
Overall, by the second followup, most families had received services related to the needs
they expressed at enrollment. At least 85 percent of families who expressed a need reported
receiving services they needed in the areas of family health care, parenting information, child
care, and education (Table IX.17). Most families who expressed a need for employment and
housing reported receiving related services. However, in two areas—transportation and services
for children with disabilities—fewer than half of families with a need received services within
the first 16 months, on average, after enrollment.
In most areas of need, the match between reported service needs and use did not change
much after the first follow-up period. Most families who received services related to their
reported needs at enrollment began receiving them in the initial follow-up period. In child care
and education, some families who had a need at enrollment and did not receive services during
the first follow-up period began receiving services in the second follow-up period.
A high proportion of families who did not report a need at enrollment nevertheless received
related services. Some services, such as parenting information, are core Early Head Start
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TABLE IX.17
MATCH BETWEEN SELECTED BASELINE NEEDS AND SERVICES USED BY PROGRAM FAMILIES
DURING THE FIRST 16 MONTHS
Average Percentage of Families Who Had:
Among Families Among Families
No Need at with a Need, Without a Need,
A Need at Baseline A Need at Baseline No Need at Baseline and Average Average
and Received but Did Not Baseline but Received No Percentage Who Percentage Who
Need Area Services Receive Services Received Services Services Received Services Received Services
Parenting Information 12 1 81 6 92 93
Services for Children with
Disabilitiesa 2 6 1 91 25 1
Child Careb 30 5 55 10 86 85
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Education 45 8 38 9 85 81
Employment 38 15 30 17 72 64
Family Health Care 28 1 70 1 97 99
Housing 9 6 41 45 60 48
Transportation 10 16 20 55 38 27
Sample Sizes 878–1,024 878–1,024 878–1,024 878–1,024 878–1,024 878–1,024
SOURCE: Parent Services Follow-Up Interviews completed an average of 7 and 16 months after enrollment.
NOTE: The percentages are average percentages across programs in the group and are weighted for survey nonresponse.
a
Families are coded as having a need for disability services if they reported that someone suspected that the child was experiencing a developmental delay, the
child had been evaluated for early intervention services, the child was identified as eligible for early intervention services, or the child was receiving early
intervention services.
b
Families were coded as having a child care need if the family reported needing child care for any child in the household.
services provided to virtually all families regardless of reported need. Thus, the proportion of
families who received services is similar among families who did and did not express a need
when they enrolled (Table IX.17). In other areas of need, families may have identified a need
after enrollment, or families’ needs may have changed as they progressed in the program, and
they received services to meet these emerging needs.
E. SUMMARY
The 17 Early Head Start research programs served diverse families with widely varying
needs and circumstances, and were successful in achieving high levels of participation among
them. Family participation patterns differed across programs. Like other home-visiting
programs, the Early Head Start home-based programs had difficulty providing the required
frequency of home visits—they succeeded in completing weekly visits with just over half their
families. The pattern was very similar for the mixed-approach programs. Case management
services overlapped considerably with home visitation, with the majority of families receiving
both. Family meetings with case managers occurred more frequently in home-based and mixed-
approach programs. Programs provided parenting education in different ways: center-based
programs used predominantly parenting classes or events, while home-based and mixed-
approach programs held more group activities with parents and children together.
Ten of the Early Head Start research programs provided center-based child development
services to some or all of their families, and many also arranged for quality care by working with
community partners. This meets important family needs, as quality, affordable, and accessible
child care is scarce for low-income families in the United States. Although children in center-
based programs received more intensive child care (at least 20 hours a week for more than half
of them) and child care for longer periods, children in all programs were in child care
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arrangements for substantial time during their first 15 months in the program. Largely because
of Early Head Start, three-fourths of the families reported no out-of-pocket child care costs.
Serving families with disabilities is as important to Early Head Start programs as it has
traditionally been throughout the history of Head Start. Program staff reported that 13 percent of
children across all programs had been identified as eligible for early intervention services (the
percentage is lower according to parent reports, but the interview question may have meant
something different to many parents). Parents in center-based programs reported the highest
identification rates. Programs were successful in ensuring that children and families received
health services—parents reported that all children had received some health services during the
evaluation period, with extremely high rates of immunizations and doctor visits for checkups.
Programs ensured that families received other health services as well, with about two-thirds of
all families having at least one member who received dental services. Early Head Start also
linked families with community services, and high percentages received education- and
employment-related services.
Program staff rated more than one-third of their families as being highly engaged in program
services. In both engagement and service receipt, the Early Head Start research programs often
showed considerable variation across the sites, with the variation associated with program
approaches and levels of implementation of the revised Head Start Program Performance
Standards. Based on the parents’ self-reports, programs that became fully implemented early
generally succeeded in delivering more frequent and intense services to their families than the
later-implemented or incompletely implemented programs.
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X. PATHWAYS TO IMPLEMENTATION AND QUALITY
Early Head Start programs are expected to grow and improve over time. In fact, the Head
Start Bureau has taken significant steps to ensure that staff monitor programs’ compliance with
the Head Start Program Performance standards, and the bureau provides guidance to programs
from the monitoring results. More important, however, programs are required to engage in
continuous improvement activities, and the Head Start Bureau has established a training and
technical-assistance system to support programs in their efforts to improve. New programs are
especially apt to grow and improve during their early years of operation, as they learn more
about families’ needs and the services and strategies that best address them.
Beyond the normal growth and development that programs are likely to experience over
time, changes in the context in which they operate have required them to adjust and adapt. The
research programs, as well as all programs funded in the early waves of Early Head Start
funding, have had to adjust to several major changes. For example, the new welfare policies that
took effect in late 1997 drastically changed the needs and prospects of some families. Resources
for child care often increased, and the implementation of child care subsidies changed in some
places. Other significant policy changes occurred in particular states and communities.
Thus, we expected to observe changes as the research programs adapted their approaches
and made both adjustments in the implementation of particular services and improvements in the
implementation of key services. In fact, we saw substantial changes. The implementation and
quality ratings presented in the previous chapters reveal the substantial growth that the Early
Head Start research programs experienced between fall 1997 and fall 1999.
Stepping back from all the individual ratings and the particular areas of implementation and
quality, it is possible to discern trends in the directions that programs moved and identify
237
common strategies that programs used to respond to changing family needs and to meet the
performance standards. Other common program experiences, key events, and circumstances also
influenced the directions that programs took and the strategies they adopted. In this chapter, we
summarize the major changes in approach and progress in implementation that programs made
during their early years, identify the common themes that characterize their early development,
note other common experiences that influenced the programs, and identify other key events and
circumstances that influenced program pathways. The following sections also examine the
strategies that the programs adopted to accomplish needed changes, highlight noteworthy
accomplishments, and identify challenges that still lie ahead.
A. CHANGES IN APPROACH AND IMPLEMENTATION LEVELS OVER TIME
The research programs began with very different amounts of experience both in serving
families with infants and toddlers and in operating Head Start programs (Administration on
Children, Youth and Families 1999a). They also began with different plans for serving families
with infants and toddlers, based on the varying needs of these families in their communities.
Although we tried to identify a few common developmental pathways followed by the Early
Head Start research programs, the complexity of program services and the variations in
communities in which they operate made it impossible to do so. Although the research programs
share common pathways along particular dimensions, when we look across dimensions and
examine different combinations of changes, each of the 17 programs emerges as unique. It is
possible, however, to identify common types of changes the programs made or experienced
along particular dimensions. We describe these next.
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1. Evolution in Program Approaches
Over time, program approaches to delivering services increased in complexity. The research
programs were initially divided about equally among center-based, home-based, and mixed-
approach strategies. By fall 1997, however, the home-based approach predominated.
Nevertheless, by fall 1999, only two home-based programs continued to rely exclusively on the
home-based approach; the others began delivering center-based services to some families either
directly or through formal partnerships with child care providers. The four exclusively center-
based programs remained center-based throughout the evaluation period.
2. Progress in Overall Program Implementation Over Time
According to our implementation ratings, all the research programs made progress toward
full implementation of key elements of the performance standards during the evaluation period.
The patterns of change and growth, however, were quite diverse.
Six programs—the early implementers—reached full implementation in fall 1997 and
maintained that level in fall 1999. These programs benefited from experience, started with a
strong focus on child development, and were not hampered by early staff turnover or leadership
changes. They continued to refine and improve the quality of their services. Many also
expanded by adding children or services. The early implementers also built in greater
accountability over time by improving internal monitoring or staff supervision, or by improving
their service-tracking systems. Figure X.1 shows the growth of one of these programs.
Six programs were not fully implemented in fall 1997 but by fall 1999 had made significant
improvements and reached full implementation. These programs—the later implementers—
often received key feedback from Head Start Bureau monitors and promptly improved services
to meet the Head Start Program Performance Standards. They often had to shift the primary
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FIGURE X.1
TIMELINE OF AN EARLY IMPLEMENTER
Families
Served
1987 Agency began home visiting program for families with children 0-5
45
Agency received CCDP and Even Start grants, created an infant/toddler
1989 center, increased community collaborations, and began helping families
120 gain access to comprehensive services
1991
1993
Agency received Parent-Child Center designation, received an Early
1995 Head Start grant, increased focus on 0-3 year-olds, operated an on-site
130 child care center for children 0-3, and integrated state funding
1997 Agency received an Early Head Start expansion grant and an interim Head
220 Start grant
Agency received permanent Head Start grant, received funding for
1999 270 building renovations, and received state funding for full-day/full-year
center-based programs
Agency expands to 3 infant/toddler centers, creates indoor playground,
increases play groups in county, and opens 2 classrooms for children 3-5
240
focus of their services from the family to the child. The home-based programs in this group
increased their attention over time to ensuring that child care for children who needed it was of
good quality. Early leadership changes were more common among the later implementers.
The remaining five programs—the incomplete implementers—were moderately
implemented in both fall 1997 and fall 1999. These were more likely to be new programs
serving families with infants and toddlers for the first time. They often received important
feedback from Head Start Bureau monitors but sometimes had trouble responding to it. They
frequently had to increase their focus on child development. The incomplete implementers were
more likely to experience high rates of staff turnover during their first year of operation and to
experience leadership changes. They were also more likely to have to change course midstream
as a result of difficulties with community partnerships. Like other programs, the incomplete
implementers increased their accountability over time by improving internal monitoring of
program services or staff supervision, and improving their tracking of service receipt.
B. THEMES CHARACTERIZING EARLY PROGRAM DEVELOPMENT
We asked program staff to look back over their early years and identify the key events that
had made a difference in their program’s growth and development. From these reports and our
own observations of changes that were common across programs, we identified a number of
themes that characterized the early development of the Early Head Start research programs.
1. Increased Attention to the Revised Head Start Program Performance Standards
Programs received ongoing guidance from the Head Start Bureau and technical-assistance
providers to help them interpret the performance standards. In addition, the research programs
received Head Start Bureau monitoring visits between our 1997 and 1999 visits. These visits
clarified the standards in the context of each program, identified areas that programs needed to
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change in order to comply with the standards, and motivated staff to address these areas. Staff in
about half the research programs mentioned visits by their federal project officer or other
technical-assistance consultants as key events in their program’s development.
2. Increased Service Intensity
Many programs increased the frequency of home visits, the hours of child care they
provided in their centers, and/or the frequency of group socializations as the requirements of the
Head Start Program Performance Standards became clearer and as family needs changed. One
home-based program planned initially to conduct home visits biweekly, but changed to weekly to
meet the revised Head Start Program Performance Standards, which took effect in January 1998.
One of the center-based programs initially offered part-time day care in its main child
development center, but increased its hours to help the growing number of families that needed
full-time child care in order to work toward self-sufficiency. Many programs increased the
frequency of group socialization activities to accommodate the varied schedules of families and
increase participation levels in group activities.
3. Increased Focus on Child Development
Some programs began with a family support focus and had to go through a process of
studying the performance standards, reevaluating their theories of change, and reexamining their
services. Increasing the child development focus of services often involved increasing the time
that was devoted to child development activities during home visits and parent activities,
changing curricula or emphases in home visits, engaging staff in intensive training on relevant
topics, and providing supervision to help staff focus more consistently on child development and
parent-child relationships during home visits. The increase in focus on child development
occurred, at least in part, in response to strong messages from Head Start Bureau monitors that
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although Early Head Start rests on four cornerstones, Early Head Start is a child development
program and the focus of services needs to be the child.
4. Refocused Efforts to Improve Child Care Quality and Availability
As it became clearer to programs that the Head Start Bureau required them to take
responsibility for the quality of child care arrangements that program children are in, many
programs began focusing on improving the availability and quality of that child care. Several
programs refocused their efforts to improve child care quality and availability from
community-level collaborations with child care providers and agencies. Either by helping Early
Head Start families find good child care arrangements or by working with providers to improve
the quality of their existing arrangements, they improved Early Head Start children’s access to
high-quality child care. Sometimes these efforts resulted in improvements in the quality of care
for other children as well. Section C describes some of the strategies that programs used to
improve child care availability and quality for enrolled children.
5. Enhanced Participation in Program Services/Activities
Some programs made strong efforts to increase family involvement in services—for
example, participation in home visits and group socializations, and involvement of males in
program activities—and succeeded to some extent in doing so. Because the new welfare
requirements often led families to give priority to work-related activities, some programs
experienced low levels of participation in program services and searched for strategies for
improving it. In addition, programs recognized the importance of involving fathers as well as
mothers in program activities and devoted resources to reaching out to them.
243
6. Expansion of Services
Many of the programs expanded their services during the evaluation period. To meet the
demand for Early Head Start services in their communities, some programs expanded the number
of children they served through new grants, either Head Start Bureau expansion grants or state
grants. In response to changing family needs, and applying lessons from their initial experiences
serving families, other programs expanded their options for providing child development
services to children and families, helping them meet their child care needs, and ensuring that
those who needed child care received high-quality care. In particular, for some families, several
programs added a center-based option, either through partnerships with community child care
providers or by opening their own center. Other home-based programs added an option in which
they conducted visits to children both at home and in their child care setting. This expansion of
program options, which increased program complexity, improved the fit between program
services and family needs.
7. Evolution of Community Partnerships
As programs gained experience working with community partners and increased their focus
on child development services, they sometimes found that their initial partnerships had become
unproductive or that they were unable to overcome difficulties that had arisen with their partners.
Some ended partnerships that had become unnecessary or were unsuccessful. Over time, most of
the programs developed new community partnerships and joined interagency collaborative
groups, often with child care providers or Part C agencies.
Changes in partnerships sometimes caused setbacks or required programs to redesign
services, and sometimes they enabled programs to solve problems more quickly. Regardless,
staff often saw these changes as key events in their programs’ development. For example, one
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program initially worked with the local resource and referral agency on strategies to improve
child care quality, but staff members encountered problems in their relationship with the agency,
ended this partnership, and went back to the drawing board to develop new strategies for
promoting quality in Early Head Start children’s child care settings. In another program, after
staff encountered difficulties in working with their partners in continuous program improvement
and ended that relationship, they eventually hired a continuous program improvement researcher
to work with them.
8. Leadership Changes
Nine programs experienced director turnover during the evaluation period, although in three
cases the director moved to a higher position within the agency. Leadership changes sometimes
set back or stalled program progress. However, sometimes they also created opportunities for
positive change. For example, the newly hired program director in one program was unable to
build necessary relationships within the grantee agency and overcome staff morale problems, and
left the program after about one year. Other staff also left around the same time. The new
director, an employee with a long history with the grantee agency, hired new people who were
better suited to their jobs and in time created a staff with high morale and strong commitment to
the program. In other programs, the departure of the program director caused some activities to
be put on hold while the program sought a new director.
9. Staff Changes
Nearly all the research programs mentioned staff changes as key events in their program’s
development, including the addition of new staff members, staff turnover in key positions, new
training for staff, and reallocations of staff responsibilities.
245
Many programs experienced moderate or high levels of staff turnover, which often disrupted
services. When programs were unable to fill staff openings quickly, families receiving home-
based services experienced periods of less-intensive or no services. Children and families also
lost the trusting relationships they had built with the staff members who left, and new staff had to
establish new relationships with them. Staff turnover sometimes required programs to “start
over” with training staff and helping them obtain their CDA credential.
10. Shift Toward Providing Training and Technical Assistance
Some programs reported that in addition to receiving training and technical assistance, they
began providing it to other, newer Early Head Start programs. Because they were in the initial
waves of program funding and further along the pathway to full implementation, the research
programs were often called on to share what they had learned and provide help to newer
programs in their region.
C. STRATEGIES FOR CHANGE
The common themes described above, as well as other changes that individual programs
made, generally came about through the conscious and concerted efforts of program staff. These
efforts employed some common strategies, which are described below. The strategies refer to
the types of actions that programs took, often as a result of the key events just described.
1. Using New Curricula and Assessment Tools
One strategy for increasing the emphasis on child development or strengthening the focus of
program services on the child was to add or change curricula. A number of programs added the
Creative Curriculum for Infants and Toddlers. One mixed-approach program began using a
common curriculum in its centers and in home visits to promote consistency and continuity when
families move between center-based and home-based services.
246
Some programs added to or changed the child assessment tools they were using. Several
programs added the Ages and Stages Questionnaires, because they are parent-friendly and offer
an opportunity for parents to participate in and learn from the assessment process.
One program designed and implemented an outcomes/best practices tool for working with
families. It was designed to improve service quality and make services more consistent across
families.
2. Creating Early Head Start Child Care Centers
Several programs expanded their child development services by creating a child care center
for some program children and to provide a model for high-quality child care in the community.
In one case, the center was designed to provide respite child care services for a limited time to
families who needed it. In another case, the center had spaces for eight children, and plans were
in place for adding additional spaces.
3. Developing New Approaches to Improving Quality in Community Child Care Settings
During the evaluation period, the research programs began many efforts to improve the
quality of child care for Early Head Start children in the community. Program staff devoted
substantial time to these efforts, and worked hard to overcome the challenges presented by the
limited supply of good-quality infant and toddler child care in their communities and the limited
capacity of many community child care providers to make the changes necessary to meet the
Head Start Program Performance Standards. Because of these challenges, some programs
focused on training strategies for improving child care quality. Several programs and their
community partners began offering free training and materials to child care providers. One
program also offered a monetary payment for attending monthly training sessions.
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Several programs began assessing quality and working with center-based and family child
care providers to improve it. One program, as it worked with providers that cared for Early Head
Start children, created individual quality enhancement plans and offered incentives, materials,
and training to encourage and enable them to develop their plan. Staff members in that program
were also beginning to visit informal neighbor and relative caregivers monthly. Another
program began paying for child care for some children and worked with the funded providers
individually to improve quality. Most of these were family child care providers.
In addition to or in place of some home visits, several programs began visiting children in
their community child care settings. During these visits, staff members shared child
development information with the providers and, when possible, offered feedback on the care of
the program child. Through these visits, program staff built relationships with Early Head Start
children’s care providers and encouraged them to work in partnership with Early Head Start on
behalf of the child.
4. Creating Systems for Tracking Services More Effectively
Several research programs made changes in their management information system and/or
their data collection procedures to facilitate access to information about families’ receipt of
services, especially health services. One program hired a consultant who helped them implement
the Head Start Family Information System (HSFIS) and streamline their data collection
procedures. Several other programs began using the HSFIS to track services or made
improvements to their existing tracking systems. The transition to using the HSFIS was
sometimes difficult for program staff, especially when staff were not accustomed to using a
computerized management information system or were used to a different system.
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5. Ending Partnerships
As already noted, changing partnerships was an important theme of change for Early Head
Start programs. Sometimes partnerships ended or changed as a result of circumstances outside
the program’s control. Sometimes the programs accomplished important changes by ending
partnerships or forming new ones. As programs gained a better understanding of the importance
of focusing on child development services, they sometimes found that the initial partnerships
they had formed no longer met their needs and should be ended. For example, one program
initially relied on a collaborative agreement with another agency to provide child development
home visits, but the agency did not provide the number of visits Early Head Start required, nor
did it provide the needed support for Early Head Start staff in this area. The program ended its
partnership with the agency, and staff members took direct responsibility for child development
services.
6. Forming New Partnerships and Strengthening Existing Ones
The breadth of partnerships the programs had with other community programs and agencies
increased over time. Programs found new partners to help them meet families’ needs. Programs
also continued participating in interagency collaborative groups, and in some cases increased
their leadership role in these groups (for example, one program became more visible and
accepted in the community over time, and the director gained leadership roles in new community
and statewide early childhood initiatives).
Many of the programs and their Part C partners began participating together in
SpecialQuest1 and working together on joint goals for improving services to families and
1
SpecialQuest refers to five-day workshops conducted as part of the Hilton/Early Head Start
Training Program, which is now part of the Head Start T/TA system. These began in 1998 with
funding from the Conrad N. Hilton Foundation. SpecialQuest emphasizes inclusion of infants
249
children with disabilities. In fall 1999, program staff reported that participation in SpecialQuest
had improved their relationships with Part C staff and that frontline staff in both programs
worked more effectively together on behalf of children with disabilities.
In their work on improving the quality of child care for enrolled children, many of the
research programs began developing partnerships with child care providers during the evaluation
period. These partnerships were both formal (involving contracts in which child care providers
agreed to meet the performance standards) and informal.
7. Reorganizing or Creating New Staff Positions
To strengthen their focus on child development, some programs created new positions and
either promoted existing staff or hired child development specialists or coordinators to support
frontline staff in this area. To boost efforts to ensure that children received immunizations and
needed health care and that staff had access to infant mental health expertise, some programs
created positions for nurses or infant mental health specialists.
8. Hiring New Staff into Existing Positions
Staff turnover presented opportunities for filling positions with new staff who better met the
needs of the program. Several programs experienced turnover and saw it as an opportunity to fill
positions with staff better suited for the job. For example, in one program, many families who
enrolled in the program were headed by teenage parents (even though teenage parents were not
explicitly the target of program recruiting efforts). Many existing frontline staff did not like
(continued)
and toddlers with significant disabilities, nurturing relationships with families, and
building/maintaining relationships with early intervention partners. SpecialQuest teams are
formed in local communities and comprise Early Head Start staff, parents of infants/toddlers
with disabilities, and early intervention staff. The teams attend the workshops and are expected
to continue working together when they return to their communities.
250
working with teenage parents, who present a unique set of challenges. As these staff left, the
program hired new staff members who were interested in and qualified to work with these
younger parents.
9. Providing Intensive Staff Training
A key strategy for programs that increased their emphasis on child development and
strengthening child development services was providing intensive training in that area to staff.
In one program, for example, the program’s continuous program improvement partner
(university researchers) provided an eight-week course on child development and working with
families and children at risk, for which staff received college credit. The program’s partner also
helped program managers arrange a Child Development Associate (CDA) class for staff and
providers who cared for Early Head Start children.
During the evaluation period, the Head Start Bureau notified programs that by September
2003, at least 50 percent of all teachers in center-based programs nationwide must have at least
an associate’s degree in early childhood or a related field.2 Many of the research programs
began providing more support for staff members to work toward their degree, such as developing
individual plans for meeting this requirement, providing tuition support, and offering release
time. One program began sponsoring a community college course in child development and
gave enrollment priority to program staff and participants. Because some local colleges and
universities did not offer degrees in early childhood development, several programs had to work
with them to establish such a course of study.
2
Head Start Act, Section 648A (a) (2), October 1998.
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10. Strengthening Staff Supervision
Some programs strengthened their supervision and support for frontline staff by hiring
additional supervisory staff, spending more time with staff in supervisory activities such as case
conferences and observations of service delivery, and improving the consistency of supervision.
In one program, managers began providing monthly feedback on performance to individual
home visitors. Another program made staff supervision more systematic and developed forms to
facilitate feedback to home visitors after managers observed visits. Yet another implemented a
new schedule for meetings and supervision sessions and refocused them on substantive issues
(versus systems and process issues).
11. Increasing Staff Salaries
Several programs revised their salary scales in an effort to increase staff retention and
attempt to establish pay equity. Two programs developed new scales based on years of
experience and level of education, which in one of the programs dramatically increased the pay
of Early Head Start teachers with degrees. Another program, which operated multiple sites,
developed a new salary scale to make compensation equitable across sites and ensure that all
staff received medical benefits. Another increased salaries for teachers and assistants to make
them competitive with those of other child care professionals in the area.
12. Seeking Additional Funding
Some programs successfully sought additional grants to support their efforts to improve
child care quality or enhance their services in other ways. For example, one program obtained
state funds to expand the number of children it could serve and to hire additional staff members
who provide intensive training and supervision to home visitors and implement continuous
quality improvement activities. Another program recently received a state grant to develop
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formal partnerships with community child care providers to help them improve the quality of
care they provide and work toward meeting the Head Start Program Performance Standards.
Another strategy that some programs offering center-based care implemented for obtaining
additional funds was to require families to apply for child care subsidies. The subsidies freed up
Early Head Start funds for enhancing or expanding other services. Not only did additional
funding increase program resources, it diversified programs’ sources of funding and made them
less dependent on a single funding source.
D. PROGRAM EXPERIENCES INFLUENCING PATHWAYS
Other aspects of the research programs’ experiences, beyond the conscious strategies they
adopted, also influenced their directions and pathways. These include their experiences prior to
becoming Early Head Start programs.
1. Conversion from Comprehensive Child Development Programs
Some former Comprehensive Child Development Programs (CCDPs) had to shift the focus
of program services from the family to the child. As CCDPs, some of the Early Head Start
research programs emphasized family support and focused on supporting parents in their
parenting role. In these programs, staff had substantial knowledge of community resources and
experience in linking families with community services that address a broad range of parenting
issues and barriers to self-sufficiency. As Early Head Start programs, they were expected to
increase their focus on child development services and take responsibility for the quality of
children’s child care arrangements. In some programs, staff resisted this shift in emphasis, and
program managers had to work with them over a period of time to get them to accept the
changes.
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The former CCDP programs also had to regain confidence after disappointing CCDP
evaluation results were released soon after they received Early Head Start funding. These results
showed that the CCDP programs had no enduring impacts five years after families enrolled in
the programs, although a pattern of positive impacts was found in one of the evaluation sites (St.
Pierre, Layzer, Goodson, and Bernstein 1997).
2. Addition of Early Head Start to Head Start Programs
The Early Head Start grantees that operated Head Start programs brought experience with
many components of the Head Start program—such as parent involvement activities, policy
councils, and community and family partnerships—to the new program. To incorporate Early
Head Start, these grantees had to shift their focus to include infants and toddlers. Staff who
moved from Head Start to Early Head Start had to adjust to new responsibilities and new work
schedules, and they needed to shift their focus to the special needs of infants and toddlers. When
training for Early Head Start and Head Start staff was integrated, training activities needed to be
reoriented to focus on infants and toddlers as well as preschool children.
Some Head Start programs had to learn to reallocate resources and promote effective
communication among staff members to become a seamless 0 to 5 program. Adding Early Head
Start to Head Start was not necessarily difficult, but when there were staffing or administrative
problems within the Head Start program, and Early Head Start was perceived as competing for
resources, tensions sometimes arose between staff members. Lack of communication between
Early Head Start and Head Start staffs also presented difficulties in some programs.
3. Community Programs Becoming Early Head Start Programs
Some new grantees brought substantial experience in serving families with infants and
toddlers to Early Head Start, but the programs did not have experience with Head Start
254
requirements, such as one to establish a policy council. These programs had to become familiar
with the Head Start Program Performance Standards and figure out how to meet them in the
context of their agency and community. For example, one program that operated in a university
setting had to reconcile university rules for program decision making with the Head Start
requirement that the Policy Council make the decisions.
E. CHANGES IN THE POLICY AND PROGRAM CONTEXT
The dynamic nature of the early implementation of the Early Head Start research programs
reflects in part their responses to a few key events and circumstances in their community, at the
state level, and nationwide. These include revisions to the Head Start Program Performance
Standards after programs were funded, welfare reform, changes in Medicaid programs, and
changes in local child care markets.
1. Revised Head Start Program Performance Standards
The enactment of the revised Head Start Program Performance Standards required some
programs to make changes in order to come into compliance. Sixteen of the research programs
were funded in the first wave of Early Head Start programs (all were in the first two waves),
before the revised Head Start Program Performance Standards went into effect. Thus, they were
at the forefront in seeking clarification of the new performance standards, and their experiences
and questions led to increased clarity in Head Start Bureau expectations.
2. Welfare Reform
Welfare reform was enacted in August 1996, shortly after the research programs were
funded, and took effect a year later. It was accompanied by consolidation of child care funding
streams and increased levels of child care funding. Many low-income parents are now required
to work or participate in work-related activities. Time limits on cash assistance and the clear
255
message that welfare recipients must work caused many parents enrolled in Early Head Start to
give priority to looking for jobs and working, rather than to participating in program activities,
including home visits. Increased participation in work and related activities also increased
parents’ needs for child care.
Welfare reform led some research programs to adjust their service delivery approaches and
modify specific services to meet the changing needs of families struggling to meet the new
welfare requirements. Some programs also built new partnerships with welfare agencies and
other community organizations that worked with parents on welfare. In response to families’
increased child care needs, some programs began working with eligible families to obtain child
care subsidies or applying for direct grants from state child care subsidy funds.
3. Changes in State Medicaid Programs
Changes in Medicaid programs sometimes required programs to change their approaches to
ensuring that children receive needed health care. The changes included shifts to managed care,
which required families to select new health care providers and follow new procedures. One
program initially formed a partnership with a local health care provider to deliver care for all
program families without a medical home, but could not rely on that partnership for health care
after the Medicaid program changed and many program families selected other health care
providers for their Medicaid managed care. Programs often helped families obtain information
and navigate the changes in the Medicaid program.
4. Local Child Care Markets
The availability and quality of child care for infants and toddlers in the community
influenced the starting point of many programs in taking responsibility for ensuring that Early
Head Start children who need it receive good-quality child care. In many of the research sites,
256
program staff described the availability of child care for infants and toddlers in the community as
insufficient and the quality of care as poor. Because good quality child care did not exist in the
community, some programs did not have the option of referring families to it or of forming
partnerships with providers to ensure that Early Head Start children received it. These programs
had to consider ways to improve the quality of existing child care, such as providing training for
child care providers, adding child care centers that could be models for good quality child care in
the community, and working on quality improvements individually with providers that cared for
Early Head Start children.
F. SOURCES OF GUIDANCE RECEIVED BY EARLY HEAD START PROGRAMS
The Early Head Start research programs learned the way to provide high-quality services
with help from a number of sources, including:
• Lessons from Experience. Lessons from their own and others’ experiences (such as
those of Comprehensive Child Development Programs, Parent Child Centers, and
other early intervention programs) helped the programs design and implement their
Early Head Start programs.
• Revised Head Start Program Performance Standards. Even though the new
standards did not become official until more than a year after most of the programs
began serving families, they guided the programs in their development because they
were available soon after programs were funded. Over time, the Head Start Bureau
and technical-assistance providers clarified and explained the new performance
standards.
• Training and Technical Assistance. The programs received varying amounts of help
and guidance from the Head Start technical-assistance network, including Quality
Improvement Center representatives, Disabilities Services Quality Improvement
Center consultants, and infant-toddler consultants from the Early Head Start National
Resource Center at ZERO TO THREE, as well as other sources of training and
technical assistance to which the programs had access.
• Head Start Bureau Monitoring Visits. Feedback and guidance from their federal
program officers helped programs find their way and sometimes led them to explore
directions they may not have considered otherwise.
• Feedback from Continuous Program Improvement Partners. Interactions with and
reports from continuous program improvement partners, often including the
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university-based local research partners, helped many programs reflect on the
services they were providing, identify needed improvements, and garner support they
needed to make changes. The nature and intensity of the program-research
partnerships varied greatly. A few research teams had regular, active involvement
with program staff, while others had little or no involvement with program staff
beyond data collection. Most researchers were not involved in program activities.
• Program Self-Assessment. Many programs conducted regular and intensive
self-assessments and used information from them to make changes.
• Participation in the National Research and Evaluation Project. Participation in the
national evaluation and local research studies provided opportunities for directors of
the research programs to meet and discuss implementation issues, and discussions
with researchers provided opportunities for directors to reflect on their programs.
G. CONCLUSIONS: MAJOR ACCOMPLISHMENTS AND REMAINING
CHALLENGES
The early implementation of the Early Head Start research programs has been dynamic. The
programs’ development and change were fast-paced, and not always in directions that were (or
could have been) anticipated. Throughout their first four years, programs made significant
progress, achieved noteworthy successes, and encountered important challenges.
1. N
oteworthy Accomplishments
The programs achieved many important successes over the first several years of
implementation. Looking back, several accomplishments stand out.
• Nearly three-quarters of the research programs became fully implemented. Twelve
out of 17 research programs, according to our strictest measures, were fully
implemented within four years of being funded. Most programs were able to reach
full implementation within four years of their initial funding. About a third reached
full implementation within the first year of serving families; another third became
fully implemented within four years of initial funding. The others made considerable
progress in a number of program areas but were not able to become fully
implemented within the first four years.
• Implementation progress occurred even while program complexity increased and
program emphases changed over time. Programs often altered their basic
approaches to providing child development services to accommodate the changing
needs of families. The changes in approaches usually entailed adding service
options. Over time, programs offered a more complex set of options to families.
258
Programs’ theories of change evolved to increasing emphasis on expected outcomes
in child development and parent-child relationships.
• The infrastructure to support Early Head Start grew alongside the programs. The
revised Head Start Program Performance Standards took effect in January 1998, and
the first monitoring visits by Head Start Bureau staff took place during spring 1998.
During this period, the training and technical-assistance system was growing to
accommodate the rapidly expanding number of Early Head Start programs. Even in
the midst of these changes, however, the research programs often cited guidance
received from Head Start Bureau monitors and training and technical-assistance
providers as key to their growth and development.
• To a large extent, the programs delivered the required services. Overall, 91 percent
of parents met at least a minimal criterion for being considered participants, and
programs delivered child development and other services to them in centers, during
home visits and case management meetings, and in group parenting activities.
Services included child development services (including child care, assessments and
screening, activities with children during home visits and group socializations),
parenting education, and family development services (including case management,
health services [mostly by referral], and transportation assistance [directly and by
referral]). Furthermore, by 16 months after enrollment, most families had received
the services that related to the needs they expressed at the time they enrolled.
• The programs succeeded in providing more intense child development services.
Programs providing home visits increased the intensity of home visits, moving from
two to three visits a month on average. Programs offering center-based services all
increased to full-day, full-year services, if they had not been offering these services
initially.
• The Early Head Start centers provided good-quality care to infants and toddlers,
and many efforts were initiated to enhance quality in community child care
programs that Early Head Start children attended. Between the fall 1997 and fall
1999 site visits, the ITERS scores consistently averaged 5.3 (in the good range).
Several programs were rated as providing excellent care. All the programs received
ITERS scores above 4, well into the minimal-to-good range. In contrast, only 31
percent of centers with infant/toddler classrooms received ITERS scores of 4 or
above in the Cost, Quality and Outcomes Study (Cost, Quality and Outcomes Study
Team 1995). Programs initiated many efforts to enhance quality in community child
care centers attended by Early Head Start children.
• Attention to staff training, supervision, and support sustained high ratings of staff
satisfaction and commitment. Over time, many programs have continued to refine
their training and supervisory approaches, and several have adapted forms and
created tools to support staff in providing consistent, high-quality services to
families. The research programs have invested a lot in staff and succeeded in
creating workplace environments that staff rated highly in the surveys they
completed at the time of our site visits. During the fall 1999 site visits, staff noted
how much they have learned and expressed confidence that they now have a much
clearer idea of what they are trying to accomplish and how to go about it.
259
• Early Head Start programs contributed to their communities. In a number of ways,
maturing programs began making a difference for the larger communities in which
they are located. For example, staff training increased the number of infant and
toddler experts in their communities; when staff move to other organizations, their
Early Head Start training and experience benefits the community; efforts to improve
child care quality are an investment in the quality of child care for all children in the
community; program efforts to help families obtain needed services lead to greater
integration of services in the community; and efforts to establish degree programs in
early childhood development at local colleges add community resources in early
childhood.
• Community partnerships grew in number and effectiveness. Early Head Start
programs have become better known and more accepted in their communities.
Special Quest has played a key role in strengthening partnerships between Early Head
Start programs and Part C providers. In addition, more programs have contracts or
agreements with child care providers.
2. Looking Ahead: Noteworthy Challenges
Looking beyond the Early Head Start research programs’ first four years of operation,
several challenges remain:
• Continuing to adjust to changing family needs. During their first four years, the
research programs adapted their services to family needs that changed as a result of
welfare reform. They are likely to continue doing so. In many states, families are just
beginning to reach time limits on cash assistance, and programs may face new
challenges if they need to help families cope with the loss. If the economy weakens,
it may become harder for families to meet the work requirements, and programs may
need to do more to help them with their employment and child care needs.
• Finding effective strategies for engaging families in parenting education and group
socializations. During their first four years, most of the research programs providing
home-based services to some or all families were unable to achieve high participation
rates in group socializations, even with efforts to vary schedules, create structured and
relevant activities for the socializations, and provide incentives for participating.
With only about half the parents in center-based programs participating in group
parent education activities, programs that were exclusively or partially center-based
continued to have difficulty engaging parents more fully in parent education classes
and support groups.
• Increasing father involvement. In searching for effective approaches to involving
parents in group socializations and parenting education, as well as in other program
activities, the programs may also discover creative ways to involve fathers.
• Ensuring that children’s child care arrangements meet the revised Head Start
Program Performance Standards. As the Head Start Bureau clarified its expectation
260
that Early Head Start programs are responsible for ensuring that the child care
arrangements of Early Head Start children meet the performance standards, the
research programs began responding in diverse ways. In many programs, this effort
was starting to gain momentum in fall 1999. Some programs set out to provide
center-based child development services and consistently provided child care that met
the standards and received good quality ratings in the research. Other programs
added center-based services to help meet the child care needs of some program
families. One program also organized a network of Early Head Start family child
care providers. Programs that had to rely on community child care settings to meet
their families’ child care needs developed a range of strategies for ensuring quality.
However, most programs that were not center-based Early Head Start programs were
not able to ensure quality child care for nearly all children who needed it and will be
challenged to continue to increase the number of community child care partnerships
to ensure quality child care.
• Balancing program needs and the needs of staff. Programs’ staffing needs are likely
to continue changing as programs evolve and services change, which will require
programs to prepare staff for new responsibilities and sometimes to change their staff
structure. In this context, programs also must meet the financial and other needs of a
more professional workforce to minimize staff turnover, which can affect programs
negatively.
The experience of the research programs shows that reaching full implementation quickly
presents a significant challenge for some programs. Reaching full implementation takes time,
and not all programs will be successful within the first three or four years of funding. All
programs and the infrastructure that supports them need to work together toward the goal of
reaching full implementation as quickly as possible.
3. Summary
The first four years of Early Head Start saw fledgling programs accept the challenges of
extending the Head Start concept to low-income pregnant women and families with infants and
toddlers. By the end of this period, 17 research programs, representing diverse approaches to
delivering comprehensive Early Head Start services, were effectively implementing significant
portions of the performance standards, while almost two-thirds of them achieved “full
implementation.” The pathways that programs followed to achieving implementation and
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quality of services included evolving program approaches characterized by adaptation to
changing needs and circumstances in the many ways described in this report. This dynamic
process meant increasing focus, complexity, and intensity, in working both with families and
within the programs’ communities. At the conclusion of the evaluation, the programs have
accomplished much, but they continue to face significant challenges. The opportunities these
challenges create provide the promise of continued growth and improvement for Early Head
Start programs.
262
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APPENDIX A
1999 CHECKLISTS
INDICATORS OF FULL IMPLEMENTATION FOR EHS PROGRAMS
Program:
Date of Site Visit:
Dimension Specific Indicators Data Sources
CHILD DEVELOPMENT CORNERSTONE
Frequency of child Enrolled children receive child development services through the following modes of service delivery: 20, 26
development services:
services for children Center-based child care/child development services provided directly by the EHS program
Average hours per week
Proportion of enrolled children who receive this service
Other developmentally appropriate child care
Average hours per week
Proportion of enrolled children who receive this service
Home visits with a child development focus
Average number of child development home visits completed per month
Proportion of parents and children who receive this service
Percentage of enrolled children who received any child development services within the past month
SOURCES OF ESTIMATES:
DESCRIPTION OF MAIN CHILD DEVELOPMENT SERVICES:
Frequency of child Of those parents who have been enrolled in the program for at least one month, percentage who have received any parent 20,23
development services: education services within the past month
services for parents
SOURCE OF ESTIMATE:
DESCRIPTION OF PARENT EDUCATION SERVICES:
1
Dimension Specific Indicators Data Sources
Developmental Program provides age-appropriate developmental assessments 76-78
assessments
Schedule for conducting assessments:
Name of instrument(s):
Percentage of children who have received age-appropriate developmental screenings in the past year
Program staff use assessment results to plan child development services.
ALL program staff who work with the child use assessment results to plan child development services.
SOURCES OF ESTIMATES:
DESCRIPTION OF HOW SERVICES ARE PLANNED USING ASSESSMENT RESULTS:
Follow up on services Percentage of children with a suspected or diagnosed disability 82-90
for children with Percentage of children with a suspected or diagnosed disability who have been referred to PartC (IF LESS THAN 100
disabilities PERCENT, RECORD THE REASON.)
Program makes vigorous efforts to recruit children with disabilities.
Program coordinates with the Part C provider to:
Develop joint individualized family service plans
Coordinate services that families receive
Ensure follow up on referrals is done quickly.
Average length of time between Part C referral and assessment/service delivery:
SOURCES OF ESTIMATES:
DESCRIPTION RECRUITMENT ACTIVITIES AND COORDINATION WITH PART C :
2
Dimension Specific Indicators Data Sources
Health services The program: 68-75
Provides comprehensive health care directly; and/or
Refers children to local health care providers and case managers monitor service delivery
Collaborates with health care providers and parents to track well child care, immunizations, and treatment plans
Ensures all children have access to dental care
Ensures all children have access to mental health counseling
Ensures that children receive needed follow up services without delay.
Percentage of children who:
Have a medical home
Have up-to-date immunizations
Have had a well-child exam in the past year
Have a treatment plan for identified conditions
SOURCES OF ESTIMATES:
DESCRIPTION OF HOW PROGRAM TRACKS HEALTH CARE SERVICES:
Child care: placement Number of program families who: 28-31, 33-34
and referral Parent guide-8
Need child care
Are receiving child care services
Program provides child care directly. Number of children served:
Program refers families to other child care providers. Number of children served:
Program helps families find quality child care providers.
Program helps families apply for child care subsidies.
Program works with families to prevent interruptions in child care subsidies and services.
SOURCES OF ESTIMATES:
DESCRIPTION OF CHILD CARE PLACEMENT AND REFERRAL ACTIVITIES:
3
Dimension Specific Indicators Data Sources
Child care: monitoring The program: 36-38,56,60, 66
and training Parent guide-8
Assesses the quality of child care settings to which it refers children to ensure that the setting meets HS performance standards.
Name of assessment tool:
Monitors the quality child care arrangements used by EHS children on a regular basis to ensure that the settings meet HS
performance standards.
Frequency of monitoring:
Provides training and support to the child care providers used by EHS families to improve the quality of child care that EHS
children receive
DESCRIBE THE CHILD CARE ASSESSMENT, MONITORING, AND TRAINING/SUPPORT ACTIVITIES CARRIED OUT BY
THE PROGRAM:
Parent involvement in The program: 115,145-146
child development
services Involves parents in planning child development services
Involves parents in planning parent education services
Involves parents in planning child development home visits
Proportion of families in which at least one parent participates in planning and/or delivery of child development services.
Of those families with a father/father figure, proportion in which the father participate in planning and/or delivery of child
development services.
DESCRIPTION OF PARENT INVOLVEMENT IN CHILD DEVELOPMENT SERVICES:
4
Dimension Specific Indicators Data Sources
Individualization of Percentage of enrolled families: 6, 93-95
services
Whose primary language is not English
Who receive child development services in their primary language
SOURCES OF ESTIMATES:
The program:
Provides child development services in a manner that respects families’ cultural and ethnic traditions with regard to child rearing
practices
Provides child development services that are tailored to the circumstances and backgrounds of individual families and children
for a few children with special needs, some children, most children, or almost all children
DESCRIPTION OF INDIVIDUALIZATION ACTIVITIES:
Group socializations The program provides group socialization activities at least two times a month for parents and children who receive child 96-102
development services primarily through home visits.
Proportion of families who regularly participate in group socialization activities
SOURCES OF ESTIMATES:
DESCRIPTION OF GROUP SOCIALIZATION ACTIVITIES:
5
Dimension Specific Indicators Data Sources
FAMILY DEVELOPMENT CORNERSTONE
Individualized family Program engages families in a process of developing individualized family partnership agreements that: 132-139, staff
partnership guide-4
agreements Identify families’ goals, strengths, and needed services
Describe timetables and strategies for achieving goals
Build upon plans developed by other programs
Are developed jointly with other programs when appropriate
Are reviewed and updated regularly
Frequency of updates:
Percentage of enrolled families for whom an individualized family partnership agreement has been developed
SOURCE OF ESTIMATE:
DESCRIPTION OF PLAN DEVELOPMENT PROCESS:
Availability of The program provides the following services directly or through referral to another agency. (INDICATE WHETHER EACH 140-142
services: service SERVICES IS PROVIDED DIRECTLY (D), PROVIDED THROUGH REFERRAL (R), OR NOT PROVIDED (N).
provided directly and
through referral Case Management
Parent support through peer support groups and other approaches
Health care for parents and other family members (including contraception/family planning)
Comprehensive prenatal and postpartum care
Prenatal education and information about breastfeeding
Mental health services for parents and other family members
Information about mental health issues such as substance abuse, child abuse and neglect, and domestic violence
Services to improve health behavior, such as smoking cessation classes and substance abuse prevention and treatment
Education and job training
Employment services
Emergency assistance
Transportation to program services
Program systematically follows up with families and service providers to ensure that families receive the services they need.
DESCRIPTION OF SERVICE PROVISION AND FOLLOW UP:
6
Dimension Specific Indicators Data Sources
Availability of DESCRIBE THE PROGRAM’S PROCEDURES FOR MONITORING SERVICE QUALITY, INCLUDING FREQUENCY OF 143
services: monitoring MONITORING, AND MAKING IMPROVEMENTS WHEN PROBLEMS ARE IDENTIFIED.
quality
Receipt of services Percentage of families who have had a meeting with their case manager in the past 30 days 20
DESCRIPTION CASE MANAGEMENT ACTIVITIES:
Parent involvement Number of staff members who are current or former EHS or HS parents 20, 145-153
Percentage of families in which at least one parent has volunteered for program activities in the past year
Of those families with a father/father figure, percentage of those with fathers who participate in planning or are otherwise
involved in program activities
SOURCES OF ESTIMATES:
DESCRIPTION OF OPPORTUNITIES FOR PARENTS TO BECOME INVOLVED AS DECISION-MAKERS, LEADERS,
VOLUNTEERS, AND STAFF MEMBERS:
STAFF DEVELOPMENT CORNERSTONE
Supervision DESCRIBE OF SUPERVISORY, MENTORING, AND OTHER STAFF SUPPORT ACTIVITIES DESIGNED TO SUSTAIN 198-204, staff
MOTIVATION AND PREVENT BURNOUT. DESCRIBE THE PERFORMANCE REVIEW PROCESS AND THE FREQUENCY guide-18,21
OF REVIEWS.
Supervision and performance review activities include observation of staff delivering services.
Training Staff development plan and curriculum: 190-197, staff guide
23-24
Are based on an assessment of staff training needs
Emphasize relationship building
Employ techniques and opportunities for practice, feedback, and reflection
Percentage of staff members who have received training in multiple areas in the past year.
DESCRIPTION OF STAFF DEVELOPMENT ACTIVITIES:
7
Dimension Specific Indicators Data Sources
Turnover Percentage of staff who have left the program during the past 12 months due to reasons other than program downsizing. 189
REASONS FOR STAFF TURNOVER:
Compensation In the program director’s opinion, staff salaries and benefits for EHS staff positions are at or above the average level for similar 205, Staff guide-25
staff in other area programs.
Staff can access the following benefits:
Tuition reimbursement
Child care
Other “family friendly” benefits (DESCRIBE)
DESCRIPTION OF HOW STAFF SALARIES AND BENEFITS COMPARE TO SIMILAR POSITIONS IN THE AREA:
Morale DESCRIBE STAFF MORALE. Staff guide-15-16
COMMUNITY BUILDING CORNERSTONE
Collaborative Estimated number of other community providers with which the program communicates regularly 158-160
relationships Average frequency of communications with other community providers
Program participates in a coordinating group of community service providers
Program has in place:
Written collaborate agreements
Informal collaborate agreements
SOURCES OF ESTIMATES:
DESCRIPTION OF COLLABORATION ACTIVITIES:
8
Dimension Specific Indicators Data Sources
Advisory committees The program has established the following advisory committees: 171-178
Health advisory committee
Other advisory committee(s) that focuses on infant and toddler issues
The health advisory committee:
Meets regularly
Frequency of meetings:
Involves other community health services providers
Discusses infant and toddler health issues
DESCRIPTION OF ADVISORY COMMITTEE ACTIVITIES:
Transition plans Of those children who are within 6 months of their third birthday, percentage who have a transition plan in place 174-178
Parents are active participants in the transition planning process.
DESCRIPTION OF TRANSITION PLANNING:
MANAGEMENT SYSTEMS AND PROCEDURES
Policy council A parent policy council has been established and meets regularly 206-208
Frequency of meetings:
The policy council is involved in making decisions about the EHS program.
DESCRIPTION OF POLICY COUNCIL ACTIVITIES:
9
Dimension Specific Indicators Data Sources
Communication A system of regular communication exists: 209-212
systems
Among staff
Between staff and parents
Between the program and the grantee agency
Between the program and the policy council and other governing bodies
The communication system facilitates two-way communication among staff, parents, the grantee agency, the policy council, and
others.
DESCRIPTION OF COMMUNICATION SYSTEMS:
Goals, objectives, and The program has developed a set of goals and objectives for the EHS program. 213-216
plans The program has developed written plans for implementing services in each program area.
Goals, objectives, and plans were developed through a collaborative planning process that included staff, parents, the policy
council, advisory councils, and other community members.
Date of most recent plan revision:
DESCRIPTION OF THE PROGRAM’S PROCESS FOR DEVELOPING GOALS, OBJECTIVES, AND PLANS:
Self-assessment The program has conducted an annual self-assessment within the past 12 months 217-220
Dare of most recent self-assessment:
Results of the self-assessment have been recorded in program records.
The self-assessment process involved staff, parents, and community members.
The results of the self-assessment have been used to make program improvements.
DESCRIPTION OF SELF-ASSESSMENT PROCESS AND RECOMMENDATIONS FOR PROGRAM IMPROVEMENTS:
10
Dimension Specific Indicators Data Sources
Community needs The program has conducted an in-depth assessment of community resources and needs within the past three years. 221-222
assessment Staff, parents, the policy council, advisory committees, and other community members were involved in the community
assessment process.
Date of most recent assessment:
DESCRIPTION OF COMMUNITY ASSESSMENT PROCESS:
Describe the community assessment process.
11
INDICATORS OF QUALITY FOR CHILD DEVELOPMENT HOME VISITS
Program:
Date of Site Visit:
Dimension Specific Indicators Data Sources
Supervision Home visitors receive supervision that includes: 123-124, 203
Support
Teaching
Evaluation
Individual supervision
Frequency of individual supervision sessions:
Group supervision
Frequency of group supervision sessions:
In-field supervision
Frequency of in-field supervision:
Supervisor has a plan or schedule for regular in-field supervision.
Home visitors report regular opportunities to discuss their experiences as home visitors with each other during staff meetings or
other group supervision activities.
DESCRIPTION OF HOME VISITOR SUPERVISION:
Training Home visitors report that they have many opportunities to participate in training. 126-128
The program’s training curriculum, plan, and/or schedule provides for many opportunities for home visitor training.
Training techniques include:
Role playing
Experiential learning
Peer teaching
In-service training follows a curriculum or plan that includes training on a variety of service areas.
All home visitors have received training in child development.
Home visitors report that they have received training in multiple areas.
DESCRIPTION OF HOME VISITOR TRAINING:
12
Home visitor hiring When hiring home visitors, the program has considered the following: 119-122
and matching
Specific program goals
The complexity of families’ needs
Roles and responsibilities of home visitors
Other (Describe.)
The program requires home visitors:
To have strong interpersonal and communication skills
To be mature (based on previous relevant experience and age)
To respect the values and beliefs of people from diverse background and cultures and to be able to respond in an appropriate and
sensitive manner to people from a variety of backgrounds
The program matches home visitors with families according to home visitors’ skills, families’ needs, and the individual
characteristics of both home visitors and families.
Of those families whose first language is not English, percentage who are matched with a home visitor who speaks their language
or involves other staff who share the linguistic and cultural background of the families in the home visits
SOURCES OF ESTIMATES:
DESCRIPTION OF HOME VISITOR HIRING AND MATCHING WITH FAMILIES:
13
Planning home visits Home visits are planned based on: 113-117, 126 Staff
guide-13-15, Parent
Clear objectives and program goals guide-13, 17
Expected outcomes
Home visitors develop plans for each visit using a curriculum or protocol that:
Includes defined child development activities that take place during home visits
Is responsive to the individual needs of families and children
Name of curriculum:
The program’s home visiting curriculum and training materials:
Encourage home visitors to build on the strengths of parents and children
Encourage home visitors to work in partnership with parents to provide child development services
Emphasize the importance of building strong relationships with parents and children and the skills needed for relationship-
building.
Home visitors report that they are able to be flexible during home visits and modify planned activities when necessary to respond
to families’ needs.
Parents report that:
They are satisfied with their home visitor
They regularly participate in planning home visits
DESCRIPTION OF HOME VISIT PLANNING:
14
Frequency of home Average number of families per home visitor reported during site visit 20, 103, 107-110,
visits and caseload Average number of hours per home visitor per week spent on home visiting Staff guide-15-16
sizes Average number of hours per home visitor per week spent on supervision/staff development activities
Average number of hours per home visitor per week spent on record keeping
SOURCES OF ESTIMATES:
Home visitors report having adequate time for completing home visits and other duties.
Average number of completed child development home visits per family per year reported during site visit
Average number of completed child development home visits per family per month reported during site visit
Percentage of families who receive at least one child development home visit per month
SOURCES OF ESTIMATES:
DESCRIPTION OF HOME VISITOR WORKLOAD AND BARRIERS THAT PREVENT COMPLETION OF HOME VISITS:
Emphasis on child Time devoted to child development and other activities in a typical child development home visit is appropriated as follows: 118
development activities
Reported by program
Percent of time spent directly with the child
Percent of time spent with the parent and child together
Percent of time spent directly with the parent for parenting education
Percent of time spent on family social services
Percent of time spent on other activities (describe other activities)
SOURCES OF ESTIMATES:
DESCRIPTION OF CHILD DEVELOPMENT ACTIVITIES CONDUCTED DURING HOME VISITS:
Addressing multiple Home visitors provide comprehensive services that address multiple family needs. 104, 113
needs Home visitors perform some case management functions, coordinating referrals to other program services or other service
providers to needed services that are not provided during the home visit.
DESCRIPTION OF HOW HOME VISITORS ADDRESS MULTIPLE NEEDS:
15
APPENDIX B
1999 RATING SCALES
EARLY HEAD START NATIONAL EVALUATION
IMPLEMENTATION RATINGS--CHILD DEVELOPMENT CORNERSTONE
Dimension 1 2 3 4 5
Frequency of Little or no evidence that Some families receive child Most families receive child Almost all families receive Almost all families receive
child families receive child development services and development services at least child development services child development services
development development and parent parent education on a regular two times per month and at least three times per month at least four times per month
services education services on a regular basis. parent education at least and parent education services and parent education services
basis (at least monthly). monthly. at least monthly. at least monthly.
Developmental Little or no evidence that the Program staff conduct or Program staff conduct or Program staff conduct or Program staff conduct or
assessments program conducts or arranges arrange for developmental arrange for periodic arrange for periodic arrange for periodic
for development assessments assessments for some developmental assessment developmental assessments developmental assessments
for children. children or assessments for most children. for almost all children. for almost all children. All
occur only at program entry. Program staff use the results program staff who work with
of these assessments to plan a child use the results of his
child development services or her assessment to plan
for each child. child development services.
Follow-up Little or no evidence of The program makes some When a disability is When a disability is When a disability is
services for coordination with Part C effort to coordinate with Part suspected, program staff suspected, staff refer the suspected, staff refer the
children with providers. Little or no evidence C providers. The program refer the family to a Part C family to a Part C provider family to a Part C provider
disabilities of efforts to recruit children makes some efforts to recruit provider. The program and follow up is relatively and work closely with the
with disabilities. children with disabilities. makes somewhat vigorous fast. Program staff work provider to coordinate
efforts to recruit children closely with the Part C services that the family
with disabilities. Almost 10 provider to coordinate receives and to develop joint
percent of enrolled families services for the family. The service plans when
have a child with an program makes vigorous appropriate. Follow up on
identified disability. efforts to recruit children referrals is relatively fast.
with disabilities, or at least The program makes
10 percent of enrolled vigorous efforts to recruit
families have a child with an children with disabilities, or
identified disability. more than 10 percent of
enrolled families have a
child with an identified
disability.
1
Dimension 1 2 3 4 5
Health services Little or no evidence that the Program staff help some Program staff ensure that all Program staff ensure that all Program staff ensure that all
program assists families in families access child health, families have a medical families have a medical families have a medical
accessing child health, dental, dental, and mental health home and have access to home and have access to home and have access to
and mental health services and services. health, dental, and mental health, dental, and mental health, dental, and mental
tracks well child visits, health services. health services. The health services. The
immunizations, and treatment program follows up to ensure program follows up to ensure
plans. that children receive needed that children receive needed
services and immunizations. services without delay. The
program systematically
tracks well child visits,
immunizations, and
treatment plans for any
identified conditions or
illnesses.
2
Draft Implementation Ratings--Child Development Cornerstone (continued)
Dimension 1 2 3 4 5
Child care Little or no evidence that the The program provides some The program assists most The program assists nearly The program assists all
program assists families who assistance to families who families who need child care all families who need child families who need child care
need child care in making child need child care by providing by providing child care care by providing child care by providing child care
care arrangements or the some child care directly, directly, providing referrals directly, providing referrals directly, providing referrals
program provides poor-quality providing referrals to child to child care providers, to child care centers and to child care centers and
child care. care providers, and/or and/or helping families find family providers, and/or family providers, and/or
helping families apply for child care and apply for child helping families find child helping families find child
child care subsidies or the care subsidies. When the care and apply for subsidies. care and apply for subsidies.
program provides minimal program refers families to Program staff assess the Program staff assess the
quality child care. other child care providers, quality of child care before quality of child care before
staff make an initial making referrals and monitor making referrals and monitor
assessment of quality or quality regularly to ensure quality regularly to ensure
monitor the quality of care that all children receive to that all children receive
provided, but may not do quality child care that meets quality child care that meets
both. Or the program may Head Start Program Head Start Program
assess and monitor care for Performance Standards. If Performance Standards. If
some EHS children in child child care subsidies are used, necessary, the program
care but not others. Or the there are no interruptions in provides child care providers
program provides a range of service. Most children are in with the training and support
quality of child care, care that the program they need to improve the
including some “low-good” assesses and monitors to quality of care that EHS
quality. If child care ensure care meets the Head children receive, including
subsidies are used, there are Start Program Performance relative providers. Nearly all
attempts to prevent Standards. Or the program children are in care that the
interruptions in service. provides good-quality child program assesses and
care. monitors to ensure care
meets the Head Start
Program Performance
Standards. Or the program
provides high-quality care.
3
Draft Implementation Ratings--Child Development Cornerstone (continued)
Dimension 1 2 3 4 5
Parent Little or no evidence that Some parents are involved in At least one parent in a At least one parent in most At least one parent in almost
involvement in program staff involve parents in planning and carrying out number of enrolled families enrolled families participates all enrolled families
child planning and delivering child child development activities participates in planning and in carrying out child participates in planning and
development development services. in home visits and/or some delivering child development development-related delivering child development
services parents are involved in the services by planning home planning activities and services by planning home
Policy Council or center visits, carrying out planning delivering child development visits, carrying out planning
activities that relate to child activities through a center services by planning home activities through a center
development. committee related to child visits, carrying out planning committee, or volunteering
development, or volunteering activities through a center in center classrooms. Of
in center classrooms. committee, or volunteering those families with a father
in center classrooms. Of or father figure, many fathers
those families with a father participate in planning or
or father figure, some fathers delivering child development
participate in planning or services.
delivering child development
services.
Individualization Little or no evidence that child Child development services Child development services Child development services Child development services
of services development services are are individualized according are individualized for some are individualized for most are individualized for almost
individualized according to the to the unique circumstances, children, according to the children, according to the all children, according to the
unique circumstances, background, and unique circumstances, unique circumstances, unique circumstances,
background, and developmental developmental progress of background, and background, and background, and
progress of each child and the child and family, but developmental progress of developmental progress of developmental progress of
family. only for a few children with the child and family. the child and family. each child and family and are
special circumstances. provided in a linguistically
and culturally appropriate
manner.
Group Little or no evidence that the The program holds group The program holds group The program holds group The program holds group
socializations program holds regular group socialization activities at socialization activities at socialization activities at socialization activities at
socialization activities for least two times per month for least two times per month for least two times per month for least two times per month for
families participating in home- families participating in families participating in families participating in families participating in
based services. home-based services, but home-based services, and home-based services, and home-based services, and
few families participate on a some families participate on most families participate on almost all families
regular basis. a regular basis. a regular basis. participate on a regular basis.
4
EARLY HEAD START NATIONAL EVALUATION
IMPLEMENTATION RATINGS--FAMILY DEVELOPMENT CORNERSTONE
Dimension 1 2 3 4 5
Individualized Little or no evidence that the The program has developed The program has The program has developed The program systematically
family program systematically develops IFPAs with some families developed IFPAs with IFPAs with almost all families, develops IFPAs with almost
partnership individualized family and provides some case most families, and most and almost all families meet all families that include
agreements partnership agreements (IFPAs) management to connect families meet with their with their case manager at least goals, an assessment of
with families and provides families with the services case manager at least once a month. IFPAs include strengths and needs, and
ongoing case management. they need. once a month. IFPAs goals, an assessment of timetables and strategies for
include goals, an strengths and needs, and achieving goals. Staff
assessment of strengths timetables and strategies for systematically learn about
and needs, and achieving goals. Program staff families’ involvement in
timetables and strategies review IFPAs regularly with other programs and build
for achieving goals. families and update them as upon these programs’ plans
needed. whenever possible. Staff
also conduct joint planning
with other service providers
when appropriate. All
IFPAs are reviewed and
updated regularly as needed.
Availability of Few family development Some family development The program either The program either provides The program either provides
services services are available from the services are available from provides services services directly, contracts with services directly, contracts
program or sought in the the program or sought in the directly, contracts with other service providers, or with other service providers,
community. community. other service providers, refers families to most of the or refers families to most of
or refers families to most services they need. Staff the services they need. Staff
of the services they need. systematically follow up with systematically follow up
families and service providers with families and service
to ensure that families receive providers to ensure that
the services they need. families receive the services
they need. Staff also assess
and monitor the quality of
services families receive and
work to make improvements
when problems are
identified.
Frequency of Few parents receive family Some parents receive family Most parents receive Most parents receive family Almost all families receive
regular family development services. development services. family development development services on a family development services
development services. regular basis. on a regular basis.
services
5
Draft Implementation Ratings--Family Development Cornerstone (continued)
Dimension 1 2 3 4 5
Parent Few parents are involved in Some parents are involved in The program encourages The program strongly The program strongly
involvement planning or carrying out planning or carrying out families to become encourages families to become encourages families to
program activities. program activities, and the involved in planning or involved in planning or become involved in the
program provides some carrying out program carrying out program activities program as decision makers,
volunteer opportunities for activities, and many and provides multiple leaders, volunteers, and staff
parents. parents are involved in opportunities for involvement members. The program
some capacity. In in policy groups and volunteer provides many opportunities
addition to participation opportunities. Most parents for involvement in planning
in policy groups, the are involved in the program in or carrying out program
program provides a some capacity. The program activities and facilitates
variety of volunteer also makes special efforts to families’ participation in
opportunities for parents. encourage father involvement. meetings and other program
The program also makes Of the families with fathers or events. Almost all parents
special efforts to involve father figures, some of the are involved in the program
fathers. fathers participate in planning in some capacity. The
or are otherwise involved in program also makes special
program activities. efforts to encourage father
involvement. Of the families
with fathers or father figures,
many of the fathers
participate in planning or are
otherwise involved in
program activities.
6
EARLY HEAD START NATIONAL EVALUATION
IMPLEMENTATION RATINGS--STAFF DEVELOPMENT CORNERSTONE
Dimension 1 2 3 4 5
Supervision Staff receive minimal Most staff receive some All staff receive some All staff receive regular All staff receive intensive
supervision, support, and supervision, support, and supervision, support, and supervision, adequate support individual and group
feedback on their performance. feedback on their feedback on their to sustain motivation and supervision, support to
performance. performance. prevent burnout, and regular sustain motivation and
feedback on their performance. prevent burnout, and regular
feedback on their
performance that is based in
part on observation of
service delivery.
Training Staff receive minimal training Most staff have participated All staff have received All staff have received training All staff have received
from the program. in at least one training training in the past year in multiple areas in the past training in multiple areas in
session in the past year. that is based on an year. Training is provided the past year. Training is
assessment of their according to a training plan that provided according to a
training needs. is based on an assessment of training plan that is based on
staff training needs. an assessment of training
needs. The program’s
approach to training
emphasizes relationship
building and provides
opportunities for practice,
feedback, and reflection.
Turnover Staff turnover is very high (40 Staff turnover is high (30 to Staff turnover is Staff turnover is low (10 to 19 Staff turnover is very low
percent or more). 39 percent). moderate (20 to 29 percent). (less than 10 percent).
percent).
Compensation Staff salaries and benefits are Staff salaries and benefits are Staff salaries and Staff salaries and benefits are Staff salaries and benefits are
very low. low. benefits are at the above the average level for above the average level for
average level for similar similar staff in other programs. similar staff in other
staff in other programs. programs. Staff can access
enhanced benefits such as
tuition reimbursement, child
care, or other “family
friendly” benefits.
7
Draft Implementation Ratings--Staff Development Cornerstone (continued)
Dimension 1 2 3 4 5
Morale Staff morale is very low. Staff morale is low. Staff morale is average. Staff morale is high. Staff morale is very high.
8
EARLY HEAD START NATIONAL EVALUATION
IMPLEMENTATION RATINGS--COMMUNITY BUILDING CORNERSTONE
Dimension 1 2 3 4 5
Collaborative The program has established The program has established The program has The program has established The program has established
relationships few collaborative relationships some collaborative established many many collaborative many collaborative
with other service providers. relationships with other collaborative relationships with other service relationships with other
service providers. relationships with other providers, and some of them service providers, and some
service providers, and are formalized through written of them are formalized
some of them are agreements. Program staff through written agreements.
formalized through communicate regularly with Program staff communicate
written agreements. other service providers to regularly with other service
coordinate services for families. providers to coordinate
services for families, and the
program participates in at
least one coordinating group
of community service
providers.
Advisory The program has not established The program has established The program has The program has established a The program has established
committees a health advisory committee. a health advisory committee, established a health health advisory committee a health advisory committee
but it does not meet regularly advisory committee which meets regularly, involves which meets regularly,
or is a pre-existing advisory which meets other community health involves other community
committee that does not occasionally to discuss services providers, and health services providers,
focus on infants and toddlers. infant and toddler issues. discusses infant and toddler and discusses infant and
health issues. toddler health issues. In
addition, the program has
established at least one other
special advisory committee
that focuses on infant and
toddler issues.
9
Draft Implementation Ratings--Community Building Cornerstone (continued)
Dimension 1 2 3 4 5
Transition plans The program has not established The program has established Although the program The program has established The program has established
procedures for facilitating the procedures for facilitating has established procedures for facilitating the procedures for facilitating
transition from EHS to HS or the transition from EHS to procedures for transition transition from EHS to HS or the transition from EHS to
other preschool programs. HS or other preschool out of EHS and follows other preschool programs. HS or other preschool
programs, but it has not them (for any children Almost all children who are programs. All children who
followed them (for any within 6 months of their within 6 months of their third are within 6 months of their
children within 6 months of third birthday), the birthday have a transition plan third birthday have a
their third birthday). procedures only address in place. transition plan in place.
the transition from EHS Parents are active
to HS and fail to address participants in the transition
the needs of families planning process.
who are not eligible for
HS. Or many children
have a transition plan in
place.
10
EARLY HEAD START NATIONAL EVALUATION
IMPLEMENTATION RATINGS--MANAGEMENT SYSTEMS
Dimension 1 2 3 4 5
Policy council Little or no evidence of a parent A parent policy council has A parent policy council A parent policy council has A parent policy council has
policy council. been established, but it does has been established and been established, meets been established, meets
not meet regularly. meets regularly. regularly, and is involved in regularly, and is actively
making decisions about the involved in making decisions
EHS program. about many aspects of the
EHS program.
Communication Little or no evidence of a regular A regular system of A regular system of A regular system of A regular system of two-
systems system of communication communication exists among communication exists communication exists among way communication exists
among program staff. program staff. among program staff and program staff, between staff among program staff,
between staff and and parents, with the grantee between staff and parents,
parents. agency, and with the policy with the grantee agency, and
council and other governing with the policy council and
bodies. other governing bodies.
Goals, objectives, Little or no evidence that the The program has a plan for The program has The program has developed The program has developed
and plans program has a plan for developing written goals, developed goals, detailed goals, objectives, and written goals, objectives, and
developing written goals, objectives, and plans for objectives, and plans for plans for each service area. plans for each service area.
objectives, and plans for each each service area, but these each service area. These goals and plans have All written goals and plans
service area. plans have only been However, some of the been updated in written form. are detailed, thorough, and
partially implemented. goals and plans need to up-to-date, and were
be updated. developed in consultation
with the program’s policy
council, advisory
committee(s), staff, parents,
and other community
members.
11
Draft Implementation Ratings--Management Systems and Procedures (continued)
Dimension 1 2 3 4 5
Self-assessment Little or no evidence that the The program has a plan for The program has The program has conducted a The program has conducted
program has planned or conducting an annual self- conducted a self- formal self-assessment in the a formal self-assessment in
conducted an annual self- assessment, but it has not assessment in the past 12 past 12 months. The results of the past 12 months. The
assessment. taken significant steps months, but the self- the assessment have been results of the assessment
towards implementing the assessment process needs documented in program have been documented in
plan. to be formalized and records. The program involved program records. The
documented in program a broad range of staff, parents, program involved a broad
records. and community members in the range of staff, parents, and
self-assessment process. community members in the
self-assessment process. The
results of the annual self-
assessment have been used to
make program
improvements.
Community needs Little or no evidence of a The program has a plan for The program has The program has conducted an The program has developed
assessment community needs assessment. conducting a community conducted an assessment assessment of community needs an in-depth community needs
needs assessment. of community needs and and resources. This assessment assessment in the past three
resources, but the has been updated in written years. The program’s policy
assessment was form in the past three years. council, advisory
conducted more than committee(s), staff, parents,
three years ago. and other community
members were involved in
the assessment process.
12
EARLY HEAD START NATIONAL EVALUATION
CHILD CARE QUALITY RATINGS
Dimension 1 2 3 4 5
Curriculum Little or no evidence that the Program has a curriculum for The program uses a child Child care provider uses a Child care provider uses a
program uses a curriculum in its its child care center, but staff care curriculum regularly curriculum that is strongly curriculum that is
child care center. do not use the curriculum for planning and integrated into the center’s individualized for each child.
regularly for planning and scheduling activities. daily activities and is If some children receive
scheduling activities. appropriate for the population home-based services and
served. child care provided directly
by the program, both
curricula are integrated.
Turnover of Turnover among direct care staff Turnover among direct care Turnover among direct Turnover among direct care Turnover among direct care
direct care staff is very high (40 percent or staff is high (30 to 39 care staff is moderate (20 staff is low (10 to 19 percent). staff is very low (less than
more). percent). to 29 percent). 10 percent).
Assigning The program does not assign Program assigns primary Program assigns primary Program assigns primary Program assigns primary
primary primary caregivers. caregivers, but staff do not caregivers, and staff caregivers, and staff adhere to caregivers, and staff adhere
caregivers adhere to their assignments adhere to their their assignments throughout to their assignments
on a regular basis. assignments during some the day. Primary caregivers throughout the day. Primary
daily activities. conduct almost all routine care caregivers conduct almost all
activities (feeding, diapering, routine care activities
nap time, etc.) for the children (feeding, diapering, nap
in their group. time, etc.) for the children in
their group. Primary
caregivers regularly
communicate with parents
and plan activities for the
children in their group.
13
Child Care Quality Ratings (continued)
Dimension 1 2 3 4 5
Monitoring the The program does not monitor The program assesses the The program may assess The program assesses the The program uses
quality of child the quality of child care settings quality of child care settings the quality of child care quality of child care settings comprehensive measures
care settings that that EHS children attend. If the to which it refers children settings prior to referring prior to referring children and and/or procedures to assess
EHS children program provides on-site care, and monitors quality in children but monitors monitors child care quality the quality of child care
attend. there is little ongoing monitoring settings that EHS children quality regularly for at regularly for most children in settings prior to referring
of quality. attend at least annually, but least half the children in care, whether or not the children and to monitor
most of the children are care. If the program program placed children in quality regularly for all
known to be in settings that provides on-site care, their child care settings. If the children in care, whether or
the program does not quality is assessed program provides on-site care, not the program placed
monitor. If the program regularly. there is ongoing quality children in their child care
provides on-site care, quality assessment and feedback to settings. If the program
is monitored at least staff. provides on-site care, there is
annually. ongoing quality assessment,
feedback to staff, and a
systematic approach to
quality improvement.
Training and The program does not provide The program provides The program provides The program provides regular The program provides in-
support for training and support to child newsletters or other some training for most training to nearly all child care service training for nearly all
providers in child care teachers and family communications that address teachers and family teachers and family providers teachers and family
care settings that providers in settings that EHS child care quality issues providers who care for who care for EHS children. If providers who care for EHS
EHS children children attend. and/or has occasional EHS children, or children are in relative care, the children according to their
attend training for teachers and provides a great deal of program provides support and individual training needs,
family providers who training for some training to some of them as and according to
provide child care in settings teachers who care for well. individualized training plans.
that EHS children attend. EHS children. If children are in relative
care, the program provides
support and training to some
of them as well.
Educational If the program provides on-site If the program provides on- If the program provides If the program provides on-site If the program provides on-
attainment of care, many teaching staff have site care, some teaching staff on-site care, most care, almost all teaching staff site care, all teaching staff
staff in EHS neither a CDA, associate’s have a CDA or are in CDA teaching staff have a have a CDA or are in CDA have a CDA or are in CDA
centers degree, nor a bachelor’s degree. training, an associate’s CDA or are in CDA training, an associate’s degree, training, an associate’s
degree, or a bachelor’s training, an associate’s or a bachelor’s degree. degree, or a bachelor’s
degree. degree, or a bachelor’s degree.
degree.
14
Child Care Quality Ratings (continued)
Dimension 1 2 3 4 5
Accreditation No child care provided by the Program is exploring Some child care Most child care provided by the All child care provided by
program is accredited by accreditation by NAEYC or provided by the program program is accredited by the program is accredited by
NAEYC or other accrediting another accrediting is accredited by NAEYC NAEYC or another accrediting NAEYC or another
organization organization for its child care or another accrediting organization accrediting organization
organization, or program
is in the accreditation
process
15
EARLY HEAD START NATIONAL EVALUATION
QUALITY OF CHILD DEVELOPMENT HOME VISITS
Dimension 1 2 3 4 5
Supervision Little or no evidence that Home visitors receive some Home visitors receive regular Home visitors receive Home visitors receive regular
home visitors receive supervision. However, supervision, but this regular individual and group individual and group
adequate supervision. supervision does not provide supervision does not include supervision that includes supervision that includes
adequate support and adequate opportunities for support, teaching, and support, teaching, and
guidance. There is little home visitors to receive evaluation. Some evaluation. Group supervision
systematic supervision for support and evaluation. Some supervisory attention is paid provides home visitors with
child development activities. supervisory attention is paid to to child development. The regular opportunities to discuss
child development supervisor goes on some their experiences with peers.
specifically. Supervisors may home visits. Home visit Particular attention is paid by
not go on home visits. Home frequency is carefully supervisors to monitoring child
visitors receive some tracked by the supervisor. development activities, and
mentoring. Home visitors receive supervisors have been on home
mentoring. visits and have a regular plan
for accompanying home
visitors on home visits. Home
visit frequency is carefully
tracked by the supervisor.
Home visitors receive
mentoring.
Training Home visitors receive little Home visitors receive some Home visitors receive some Home visitors have regular Home visitors have many
training. training. training in several subject opportunities to participate in opportunities to participate in
areas. training. Home visitors have training. Training techniques
received training in child include role playing,
development. experiential learning, and peer
teaching. Home visitors are
cross-trained in multiple areas,
including child development.
16
Child Development Home Visit Quality Ratings (continued)
Dimension 1 2 3 4 5
Home visitor Little or no evidence that the Some evidence that the The program has considered The program has considered The program has considered
hiring and program considered program program considered program program goals, needs and program goals, needs and program goals, needs and
matching goals, needs and goals, needs and characteristics of parents and characteristics of parents and characteristics of parents and
characteristics of parents and characteristics of parents and children, and home visitors’ children, and home visitors’ children, and home visitors’
children, and home visitors’ children, and home visitors’ roles when hiring home roles when hiring home roles when hiring home
roles when hiring home roles when hiring home visitors. The program seeks to visitors. The program seeks visitors. The program seeks to
visitors. visitors. hire home visitors who are to hire home visitors who are hire home visitors who are
mature and have strong mature, have strong mature, have strong
interpersonal skills. interpersonal skills, value interpersonal skills, value
diversity, and are able to diversity, are flexible, want to
respond appropriately to learn, and are able to respond
parents and children from a appropriately to parent and
variety of backgrounds. children from a variety of
backgrounds. The program
attempts to match parents and
children with home visitors
who share the same linguistic
and cultural background and
who can best respond to the
individual needs and situations
of parents and children.
Retention of Turnover among home Turnover among home Turnover among home Turnover among home Turnover among home visitors
home visitors visitors is very high (40 visitors is high (30 to 39 visitors is moderate (20 to 29 visitors is low (10 to 19 is very low less than 10
percent or more). percent). percent). percent). percent).
17
Child Development Home Visit Quality Ratings (continued)
Dimension 1 2 3 4 5
Planning home Little or no evidence that Some evidence that home Home visits are planned based Home visits are planned Home visits are planned based
visits home visits are planned visits are planned based on on program goals and based on program goals and on program goals and expected
based on clear goals and program goals and expected expected outcomes. Home expected outcomes. Home outcomes. Home visitors
expected outcomes. outcomes, but home visitors visitors use a curriculum or visitors develop plans for develop plans for each visit
do not use a curriculum or protocol to guide child each visit using a curriculum using a curriculum or protocol
protocol to guide child development activities that or protocol to guide child to guide the child development
development activities that take place during the home development activities that activities that take place during
take place during the home visit. take place during the home the home visit, but they
visit. visit, but they individualize individualize the visits to meet
planned activities to meet the the needs of individual parents
needs of individual parents and children. Home visitors
and children. strive to develop strong
relationships with parents and
children, build on the strengths
of parents and children, and
work in partnership with
parents to plan child
development activities.
Frequency of Little or no evidence that Home visitors visit most of Home visitors visit most Home visitors visit most Home visitors visit almost all
home visits home visitors visit parents the parents and children who parents and children who are parents and children who are parents and children who are
and caseload and children receiving home- are receiving home-based receiving home-based services receiving home-based receiving home-based services
sizes based services on a regular services at least monthly. at least two times per month. services at least three times at least four times per month,
basis. per month, and caseload and caseload sizes permit
sizes permit adequate time adequate time for completing
for completing home visits home visits and other duties.
and other duties.
Emphasis on Little or no evidence that Home visitors spend some Home visitors typically spend Home visitors typically Home visitors typically spend
child home visitors spend time on time during some home visits some time during each home spend at least half an hour 45 minutes or more during
development child development activities on child development visit on child development during each home visit on each home visit on child
activities during home visits. activities. activities with the child or the child development activities development activities with the
parent and child together. with the child or the parent child or the parent and child
and child together. together.
18
Child Development Home Visit Quality Ratings (continued)
Dimension 1 2 3 4 5
Integrating Little evidence that home Some attempts by home Home visitors providing child Home visitors providing Home visitors providing child
home-based visitors providing child visitors providing child development services child development services development services
services with development services development services to coordinate with other home coordinate systematically coordinate systematically and
other services coordinate with other home coordinate with other home visitors, child care providers, and regularly with some regularly with all service
visitors, child care providers, visitors, child care providers, Part C staff, and other service home visitors, child care providers who are working with
or other service providers. or other service providers, but providers, but not on a providers, and service the same children and families,
coordination is not consistent systematic basis. providers who are working including other home visitors,
or systematic. with the same children and child care providers, Part C
families, but they do not staff, and other service
coordinate systematically providers.
with all service providers.
19
APPENDIX C
EARLY HEAD START OUTCOMES IN STAFF DEVELOPMENT AT THE
WASHINGTON STATE MIGRANT COUNCIL
EARLY HEAD START OUTCOMES IN STAFF DEVELOPMENT AT THE
WASHINGTON STATE MIGRANT COUNCIL
Joseph J. Stowitschek and Eduardo J. Armijo
University of Washington
OVERVIEW
A consistent need identified by human service agencies is the recruitment and retention of
qualified bilingual and culturally-sensitive personnel. Often, the persons who have the
appropriate linguistic and cultural qualifications are not trained to provide the levels of services
needed by families. Staff development is identified as one of the “cornerstones” of Early Head
Start (along with an emphasis on children, families, and communities), and is a major component
of the Washington State Migrant Council’s (WSMC) Early Head Start project. Upon receiving
funding, WSMC sought to include this component as a priority for the research partnership.
WSMC also felt that because of the make-up of the families being served (mostly migrant and
Hispanic farmworking families) a qualified, well-trained staff with opportunities for growth and
development, would be essential to ensure that the diverse needs displayed by these families are
met.
The WSMC staff has received training in several areas over the course of the project, as well
as educational incentives as part of an overall staff development effort. Areas of training, which
were designed to help families, included: brain development, conflict and anger management,
proper food preparation, disabilities training, and transition services. Much of this training was
directed at refining and prioritizing focus areas to work with families, and also to enhance overall
service delivery methodology.
The following is a summary of findings resulting from surveys and interviews of staff
regarding personal and professional growth they feel resulted from being a part of the WSMC
Early Head Start project, and how this helped shape their service delivery efforts. These findings
C.3
are based on ongoing research being conducted by the University of Washington as part of the
national Early Head Start research initiative.
METHODS USED
Two protocols, developed by University of Washington staff, were used to provide
information: the “Staff Development Interview” and the “Family Services Information
Questionnaire.” The “Staff Development Interview” provided data pertaining to: staffs’
educational goals and career aspirations; training; and incentives and disincentives for personal
and professional growth. The “Family Services Information Questionnaire” provided data
pertaining to service delivery focus areas and methods. The “Staff Development Interview” was
completed in one-on-one interviews with WSMC Early Head Start staff, and the “Family
Services Information Questionnaire” was completed by WSMC Early Head Staff during a
records review process. Service delivery staff included six Home Educators and two Case
Managers, the Project Coordinator, and the Project Director.
STAFF DEVELOPMENT OUTCOMES
Staff Educational Goals/Career Aspirations. Interviews revealed that four of the WSMC
staff had attained some degree of post-secondary education, another four had Associates of Arts
degrees, and two had Bachelor’s degrees related to their roles. When asked what levels of
education they aspired to, seven indicated that attaining a Bachelor’s degree was a goal, and six
indicated that attaining a Master’s level degree was also a goal. One staff member indicated that
she would eventually like to obtain a doctorate level degree.
To help staff attain these goals, WSMC offered incentives to their staff to encourage them to
continue with their education. This included an education-reimbursement package (including
100% tuition, books, mileage, childcare) and flex time schedules to accommodate coursework.
C.4
On a scale of 1 to 5, with 1 being “Discourage” and 5 being “Encourage,” Early Head Start staff
uniformly rated WSMC’s efforts in this area with a “5.”
Many of the staff’s educational goals were directly related to career aspirations. When
asked what position(s) they would like to hold in the future, one of the staff indicated that she
would like to eventually run a certified daycare center; four would like to transition to a full-time
case management position; three would like to become teachers (either with Head Start or a
public school); three would like to eventually become coordinators or supervisors of a programs
that serve families; one would like to become a higher-level program administrator; and one
individual would like to eventually become a public school administrator.
Training. WSMC reported placing a heavy emphasis on staff development through
training, both within and outside of the agency. Areas of training received included: child
development (e.g., brain development, disabilities); conflict and anger management; transition
services; and even proper food preparation. During a given year, staff received an average of
nearly fifty-five hours of training, gaining knowledge to help in their service delivery efforts, as
well as to pass on to families.
Staff were asked to rate how this training contributed to their professional skills and career
advancement. A 1 to 5 scale was used, with 1 being “Not at all Contributive” and 5 being “Very
Contributive.” In the area of how trainings contributed to their professional skills, staff rated this
an average 4.5. In the area of how the trainings contributed to their career advancement, staff
rated this an average 4.3 (see Table 1).
C.5
TABLE 1
CONTRIBUTION OF TRAININGS ON A 1 TO 5 SCALE
Training Title Contributes to Profession Contributes to Career
Brain Development 5.0 3.5
YAC Brain Development 4.5 4.5
Developing Capable People 4.5 4.5
Conflict/anger Management 5.0 5.0
Sharing (Early) Horizons 4.0 4.0
Transition 4.2 4.3
Queso Fresco 4.1 3.7
Disabilities 5.0 5.0
Infant/Toddler 5.0 4.0
Special Quest 4.0 4.0
Average 4.5 4.3
(1=Not at All Contributive, 5=Very Contributive
Incentives and Disincentives. Personnel were queried regarding incentives and
disincentives connected with their jobs as Early Head Start staff. Areas of interest included job-
related incentives (e.g., pay, outside trainings), inservice training provided by WSMC, attitudes
of co-workers, and attitudes of WSMC supervisors and administrators. A 1 to 5 scale was used,
with 1 being “Discourage” and 5 being “Encourage.” On the average, staff rated job-related
incentives at 4.1, WSMC training at 3.9, co-worker attitudes at 3.2, and
supervisors/administrators attitudes at 4.0 (see Figure 1).
C.6
FIGURE 1
STAFF INCENTIVE AND DISINCENTIVE RATINGS ON A 1 TO 5 SCALE
Incentives/Disincentives
Encourage 5
4.1 4
3.9
4
3.2
3
2
Discourage 1
Job-Related Training by Co-Worker Attitudes Supervisor's Attitude
Organization
(1=Discourage, 5=Encourage)
In response to open-ended questions, Early Head Start staff in general indicated that WSMC
and the Early Head Start program neither hindered nor otherwise prevented them from acquiring
personal or professional goals. Indeed, as seen above, growth in these areas is strongly
encouraged by the agency and program. In addition to professional growth, many of the staff
feel they have been personally enriched by the program in areas such as raising their own
children, reaching out to families in need, and increasing their own self-esteem and self-
confidence.
DISCUSSION
The staff development features explored in this study suggest that the WSMC Early Head
Start project is highly committed to the cornerstone of Staff Development. But how do the
above areas relate to services being delivered to families? Early Head Start staff uniformly
C.7
indicated that the incentives received as part of their jobs had a spill-over effect with the families
they worked with. For example, over a three-year period staff reported 26% average increases in
hours spent with families as part of regular visits, as well as over 300% average increases in
hours spent training families in project-related areas (e.g., child development issues, proper food
preparation). In addition, staff reported nearly 400% average increases in contact with families
over the phone.
There has also been a shift in focus areas during the same three-year period. An increase in
the percentage of time spent in the areas of mental health, nutrition, child language development,
and father involvement was reported by Early Head Start staff. Additionally, staff reported an
increase in the percentage of time spent in specific service delivery methods (both direct and
indirect) during this time. Specific areas included coaching families, providing praise and
feedback to families, problem solving, assessing and evaluation, verbal pointers, and arranging
resources for families.
Most of the Early Head Start staff we studied were derived from the same Hispanic roots as
the Early Head Start families they served, only one or two generations removed. Thus, their
professional successes and advancements reflect the hopes, aspirations, and opportunities that are
strived for with these younger, poorer Hispanic families. For rural Early Head Start, the
demonstration of professional growth and advancement is an outcome of critically high import.
C.8
